Fatigue Behavior of Adult Cortical Bone: The Influence of Mean Strain and Strain Range

Carter, Dennis R.; Caler, William E.; Spengler, Dan M.; Frankel, Victor H.

doi:10.3109/17453678108992136

Cited by 341 publications

(152 citation statements)

References 19 publications

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“…Control of cortical bone remodeling has been hypothesized to be dominated by error signals from loading situations to which the bone was not habituated. 30,31 Applying this principle to our loading regime on trabecular bone suggests that the novel distribution of strains in a non-habitual loading direction should elicit a robust adaptive anabolic response. Within-subject effect of loading (loaded, control limbs), between subject effect of load magnitude (0.5 and 1.0 MPa), and interactions between these terms were assessed using a repeated measures ANOVA.…”

Section: Discussionmentioning

confidence: 99%

Trabecular bone adaptation to loading in a rabbit model is not magnitude‐dependent

Yang¹,

Willie²,

Beach³

et al. 2013

Journal Orthopaedic Research

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Although mechanical loading is known to influence trabecular bone adaptation, the role of specific loading parameters requires further investigation. Previous studies demonstrated that the number of loading cycles and loading duration modulate the adaptive response of trabecular bone in a rabbit model of applied loading. In the current study, we investigated the influence of load magnitude on the adaptive response of trabecular bone using the rabbit model. Cyclic compressive loads, producing peak pressures of either 0.5 or 1.0 MPa, were applied daily (5 days/week) at 1 Hz and 50 cycles/day for 4 weeks post-operatively to the trabecular bone on the lateral side of the distal right femur, while the left side served as an nonloaded control. The adaptive response was characterized by microcomputed tomography and histomorphometry. Bone volume fraction, bone mineral content, tissue mineral density, and mineral apposition rate (MAR) increased in loaded limbs compared to the contralateral control limbs. No load magnitude dependent difference was observed, which may reflect the critical role of loading compared to the operated, nonloaded contralateral limb. The increased MAR suggests that loading stimulated new bone formation rather than just maintaining bone volume. The absence of a dose-dependent response of trabecular bone observed in this study suggests that a range of load magnitudes should be examined for biophysical therapies aimed at augmenting current treatments to enhance long-term fixation of orthopedic devices. Keywords: trabecular bone; bone adaptation; rabbit; microcomputed tomography; mechanical stimulation Mechanical loading plays a central role in skeletal development and maintenance via both modeling and remodeling processes. 1-3 Throughout life the skeleton adapts by changing bone mass and architecture to the functional demands placed on it by mechanical stimuli. In cortical bone, loading must be dynamic rather than static to elicit an anabolic response 4 and adaptive remodeling is preferentially responsive to short periods of strain change. 5 For example, high-magnitude strains, varied by regulating the applied load 6-8 and strain rate, 9 enhanced cortical bone mass.Age-related bone loss, disuse-related bone loss, bone healing, and osseointegration around implants are all intimately coupled with the mechanical loading environment in trabecular bone. Despite the importance of studies on cortical diaphyseal bone adaptation to mechanical loading, prevention and treatment of osteoporosis and osteoarthritis requires investigation of trabecular bone adaptation. In addition, important questions remain concerning trabecular bone functional adaptation to a variety of loading parameters.Well-controlled and minimally invasive experimental models of loading in trabecular bone have been difficult to develop. [10][11][12][13] In vivo intermittent compressive loading via a hydraulic bone chamber stimulated bone matrix synthesis in trabecular bone of the canine tibial and femoral metaphyses. 14 While clearl...

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Section: Discussionmentioning

confidence: 99%

Trabecular bone adaptation to loading in a rabbit model is not magnitude‐dependent

Yang¹,

Willie²,

Beach³

et al. 2013

Journal Orthopaedic Research

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“…Although the LIV signals examined are certainly small compared to what is experienced during strenuous activity, they are also within a range that will not precipitate fractures. LIV in sheep generated P2P strains of no more than five micro strain, 34 which is far lower than the 6800 micro strain 35 reported as the yield strain of bone, and yet these signals were anabolic to bone. Further investigation of body composition and vibration attenuation should be performed in the SCI population, as has been reported in the general population.…”

Section: Discussionmentioning

confidence: 99%

Transmission of low-intensity vibration through the axial skeleton of persons with spinal cord injury as a potential intervention for preservation of bone quantity and quality

Asselin

Spungen

Muir

et al. 2011

The Journal of Spinal Cord Medicine

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Background/objective: Persons with spinal cord injury (SCI) develop marked bone loss from paralysis and immobilization. Low-intensity vibration (LIV) has shown to be associated with improvement in bone mineral density in post-menopausal women and children with cerebral palsy. We investigated the transmissibility of LIV through the axial skeleton of persons with SCI as an initial approach to determine whether LIV may be used as a clinical modality to preserve skeletal integrity. Methods: Transmission of a plantar-based LIV signal (0.27 ± 0.11 g; 34 Hz) from the feet through the axial skeleton was evaluated as a function of tilt-table angle (15, 30, and 45°) in seven non-ambulatory subjects with SCI and ten able-bodied controls. Three SCI and five control subjects were also tested at 0.44 ± 0.18 g and 34 Hz. Transmission was measured using accelerometers affixed to a bite-bar to determine the percentage of LIV signal transmitted through the body. Results: The SCI group transmitted 25, 34, and 43% of the LIV signal, and the control group transmitted 28, 45, and 57% to the cranium at tilt angles of 15, 30, and 45°, respectively. No significant differences were noted between groups at any of the three angles of tilt. Conclusion: SCI and control groups demonstrated equivalent transmission of LIV, with greater signal transmission observed at steeper angles of tilt. This work supports the possibility of the utility of LIV as a means to deliver mechanical signals in a form of therapeutic intervention to prevent/reverse skeletal fragility in the SCI population.

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“…We compared bone volume above 1% and 2% of octahedral shear strain as these strain levels are often associated with bone yield (Carter et al, 1981;Lammentausta et al, 2006;Morgan and Keaveny, 2001). Difference in strain distribution within the bone volume in two cases was estimated using a two-sample KolmogorovSmirnov test with 95% confidence interval.…”

Section: Patellar Cutmentioning

confidence: 99%

A patient-specific model of total knee arthroplasty to estimate patellar strain: A case study

Latypova

Arami

Becce³

et al. 2016

Clinical Biomechanics

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Background: Inappropriate patellar cut during total knee arthroplasty can lead to patellar complications due to increased bone strain. In this study, we evaluated patellar bone strain of a patient who had a deeper patellar cut than the recommended. Methods: A patient-specific model based on patient preoperative data was created. The model was decoupled into two levels: knee and patella. The knee model predicted kinematics and forces on the patella during squat movement. The patella model used these values to predict bone strain after total knee arthroplasty. Mechanical properties of the patellar bone were identified with micro-finite element modeling testing of cadaveric samples. The model was validated with a robotic knee simulator and postoperative X-rays. For this patient, we compared the deeper patellar cut depth to the recommended one, and evaluated patellar bone volume with octahedral shear strain above 1%. Findings: Model predictions were consistent with experimental measurements of the robotic knee simulator and postoperative X-rays. Compared to the recommended cut, the deeper cut increased the critical strain bone volume, but by less than 3% of total patellar volume. Interpretation: We thus conclude that the predicted increase in patellar strain should be within an acceptable range, since this patient had no complaints 8 months after surgery. This validated patient-specific model will later be used to address other questions on groups of patients, to eventually improve surgical planning and outcome of total knee arthroplasty.

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Fatigue Behavior of Adult Cortical Bone: The Influence of Mean Strain and Strain Range

Cited by 341 publications

References 19 publications

Trabecular bone adaptation to loading in a rabbit model is not magnitude‐dependent

Trabecular bone adaptation to loading in a rabbit model is not magnitude‐dependent

Transmission of low-intensity vibration through the axial skeleton of persons with spinal cord injury as a potential intervention for preservation of bone quantity and quality

A patient-specific model of total knee arthroplasty to estimate patellar strain: A case study

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