Measurement of bone electrical impedance in fracture healing

Yoshida, Takashi; Kim, Wook-Cheol; Kawamoto, Koei; Hirashima, Toshiko; Oka, Y.; Kubo, Toshikazu

doi:10.1007/s00776-009-1333-z

Cited by 24 publications

(22 citation statements)

References 26 publications

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“…Our results are consistent with previous findings that describe an increase in |Z| over healing time . However, our study provides more comprehensive information about the behavior of θ as a function of frequency and time.…”

Section: Discussionsupporting

confidence: 93%

“…Because EIS can capture changes in dielectric properties and a healing fracture is dominated by different tissues, it may be able to uniquely complement a technique like X‐ray that relies on tissue mineralization by providing quantitative local information about the fracture callus, particularly at early stages. In addition, prior work has used EIS to track differences over healing time between fracture and control groups . While these data are promising, these studies are limited to fractures treated via external fixation using long metal pins as electrodes.…”

mentioning

confidence: 99%

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New opportunities for fracture healing detection: Impedance spectroscopy measurements correlate to tissue composition in fractures

Lin

Yang

Herfat

et al. 2017

Journal Orthopaedic Research

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Accurate evaluation of fracture healing is important for clinical decisions on when to begin weight-bearing and when early intervention is necessary in cases of fracture nonunion. While the stages of healing involving hematoma, cartilage, trabecular bone, and cortical bone have been well characterized histologically, physicians typically track fracture healing by using subjective physical examinations and radiographic techniques that are only able to detect mineralized stages of bone healing. This exposes the need for a quantitative, reliable technique to monitor fracture healing, and particularly to track healing progression during the early stages of repair. The goal of this study was to validate the use of impedance spectroscopy to monitor fracture healing and perform comprehensive evaluation comparing measurements with histological evidence. Here, we show that impedance spectroscopy not only can distinguish between cadaver tissues involved throughout fracture repair, but also correlates to fracture callus composition over the middle stages of healing in wild-type C57BL/6 mice. Specifically, impedance magnitude has a positive relationship with % trabecular bone and a negative relationship with % cartilage, and the opposite relationships are found when comparing phase angle to these same volume fractions of tissues. With this information, we can quantitatively evaluate how far a fracture has progressed through the healing stages. Our results demonstrate the feasibility of impedance spectroscopy for detection of fracture callus composition and reveals its potential as a method for early detection of bone healing and fracture nonunion. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2620-2629, 2017.

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Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 99%

New opportunities for fracture healing detection: Impedance spectroscopy measurements correlate to tissue composition in fractures

Lin

Yang

Herfat

et al. 2017

Journal Orthopaedic Research

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“…As a factor elevating the impedance, reduction of callus cross-sectional area, i.e. reduction of the conduction pathway, was substantially involved, as previously observed in a rabbit fracture model (Yoshida et al 2009), and a strong negative correlation was noted between the callus sectional area and maximum bending stress. This shows that the reduction of callus cross-sectional area influences the elevation of impedance as the mechanical strength increases.…”

Section: Discussionsupporting

confidence: 70%

“…Hirashima et al (2009) measured overall impedance in patients with a distal end fracture of the radius and they reported that impedance values increased concomitant with bone union. We also investigated the increases in overall impedance according to the fracture healing process and found that the values peaked at the time when mechanical strength reached a plateau (Yoshida et al 2009). However, there have been no studies analyzing the changes in impedance values of distraction callus, and the reasons for the temporal increases in impedance values of bone with intramedullary blood flow still remain unknown.…”

Section: Discussionmentioning

confidence: 99%

“…Previous investigations of bone electrophysiology have shown the electrical and dielectric behavior of bone (Saha and Williams 1995), and the mechanical properties of human trabecular bone have been evaluated by electrical measurements (Sierpowska et al 2005). We have previously reported increases in the electrical impedance of bone during fracture healing (Yoshida et al 2009), focusing on both evaluation of bone and the fracture healing process. We investigated both bone conductivity and the conduction pathway itself, and we observed close involvement of the conduction pathway in the increase in impedance.…”

mentioning

confidence: 99%

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Assessment of distraction callus in rabbits by monitoring of the electrical impedance of bone

et al. 2010

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Background and purposeEvaluation of distraction callus is important for determination of the optimal time for removal of external fixation. We attempted to determine whether there might be a relationship between the electrical impedance of bone and callus maturation, with a view to using impedance as a way of knowing when to remove a fixator.MethodsWe applied an external lengthener to the right tibia of 24 rabbits and performed distraction at 1 mm/day for 10 days. Radiographs were taken and measurement of overall impedance between fixation pins was performed weekly after distraction. At weeks 2, 4, 6, and 8 after distraction (n = 6 each), resistivity of the bone to electrical conductivity was measured before killing. Cross-sectional area of the conduction pathway in callus and maximum bending stress were measured after excision of the tibia.ResultsThe overall impedance increased statistically significantly from 1 to 6 weeks after completion of distraction. The resistivity of bone decreased over 4 weeks and the cross-sectional area of callus decreased significantly over 6 weeks, while the maximum bending stress increased significantly over the same time. We observed a negative correlation between the cross-sectional area of callus and maximum bending stress.InterpretationThe impedance values, which are related to changes in electrical conductivity and the conduction pathway, increased due to the changes in the cross-sectional area of callus, despite the reduction in bone resistivity. Since the cross-sectional area of callus was correlated with maximum bending stress and the impedance values increased with the callus-remodeling process, we suggest that temporal increases in overall impedance reflect callus maturation.

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Theoretical model of a piezoelectric composite spinal fusion interbody implant

Tobaben

Domann

Arnold

et al. 2013

J Biomedical Materials Res

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Failure rates of spinal fusion are high in smokers and diabetics. The authors are investigating the development of a piezoelectric composite biomaterial and interbody device design that could generate clinically relevant levels of electrical stimulation to help improve the rate of fusion for these patients. A lumped parameter model of the piezoelectric composite implant was developed based on a model that has been utilized to successfully predict power generation for piezoceramics. Seven variables (fiber material, matrix material, fiber volume fraction, fiber aspect ratio, implant cross-sectional area, implant thickness, and electrical load resistance) were parametrically analyzed to determine their effects on power generation within reasonable implant constraints. Influences of implant geometry and fiber aspect ratio were independent of material parameters. For a cyclic force of constant magnitude, implant thickness was directly and cross-sectional area inversely proportional to power generation potential. Fiber aspect ratios above 30 yielded maximum power generation potential while volume fractions above 15% showed superior performance. This investigation demonstrates the feasibility of using composite piezoelectric biomaterials in medical implants to generate therapeutic levels of direct current electrical stimulation. The piezoelectric spinal fusion interbody implant shows promise for helping increase success rates of spinal fusion.

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Measurement of bone electrical impedance in fracture healing

Cited by 24 publications

References 26 publications

New opportunities for fracture healing detection: Impedance spectroscopy measurements correlate to tissue composition in fractures

New opportunities for fracture healing detection: Impedance spectroscopy measurements correlate to tissue composition in fractures

Assessment of distraction callus in rabbits by monitoring of the electrical impedance of bone

Theoretical model of a piezoelectric composite spinal fusion interbody implant

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