Model of the distraction callus tissue behavior during bone transport based in experiments in vivo

Mora‐Macías, Juan; Reina-Romo, Esther; Domı́nguez, J.

doi:10.1016/j.jmbbm.2016.04.016

Cited by 20 publications

(47 citation statements)

References 40 publications

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“…In comparison to the work of Mora-Macías et al [ 33 ] who reported that the residual force consistently reached 25% or less of the peak force measurement, our preliminary results indicate that up to 50% of the traction is maintained toward the end of the distraction phase. Although, the full statistical analysis of our completed experiments may reduce the difference in experimental observations, the differences in the experimental models already mentioned may also contribute to the observed discrepancy.…”

Section: Discussionsupporting

confidence: 57%

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Novel systems for the application of isolated tensile, compressive, and shearing stimulation of distraction callus tissue

2017

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BackgroundDistraction osteogenesis is a procedure widely used for the correction of large bone defects. However, a high complication rate persists, likely due to insufficient stability during maturation. Numerical fracture healing models predict bone regeneration under different mechanical conditions allowing fixation stiffness optimization. However, most models apply a linear elastic material law inappropriate for the transient stresses/strains present during limb lengthening or segment transport. They are also often validated using in vivo osteotomy models lacking precise mechanical regulation due to the unavoidable stimulation of secondary interfragmentary motion during ambulation under finitely stiff fixation. Therefore, in order to create a robust numerical model of distraction osteogenesis, it is necessary to both characterize the new tissue’s viscoelasticity during distraction and determine the influence of strictly isolated stimulation in each loading mode (tension, compression, and shear) to account for potential differences in mechanical and histological response.AimTwo electromechanical fixators with integrated load cells were designed to precisely perform and monitor in vivo lateral distraction and isolated stimulation in sheep tibiae using a mobile, hydroxyapatite-coated titanium plate. The novel surgical procedure circumvents osteotomy, eliminating the undesirable and unquantifiable mechanical stimulation during ambulation.MethodsAfter a 10-day post-surgery latency period, two 0.275 mm distraction steps were performed daily for 10 days. The load cell collected data before, during, and after each distraction step and was terminated after no less than one minute from the time of distraction. A 7-day consolidation period separated the distraction phase and 18-day stimulation phase. Stimulation was carried out in isolated tension, compression, or shear while recording force/time data. Each stimulation session consisted of 120 cycles with a magnitude of either 0.1 mm or 0.6 mm in the tension and compression groups and 1.0 mm in the shear group. The animals were euthanized after a 3-day holding period following stimulation.ResultsOur initial results show that the tissue progressively stiffens and maintains an increasingly large residual traction. The force curves during compressive stimulation show a progressive drift from compression toward tension. We hypothesize that this behavior may be due to the preferential flow of fluid outward from the tissue and a greater resistance to reabsorption during the plate’s return to the starting position.

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Section: Discussionsupporting

confidence: 57%

“…They found a stiffness of 0.61–1.27 MPa for granular tissue [ 32 ]. Mora-Macías et al have reported an instantaneous modulus between 0–15 MPa in a bone segment transport model in the ovine metatarsus [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Novel systems for the application of isolated tensile, compressive, and shearing stimulation of distraction callus tissue

2017

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“…There are in vivo studies in BT that experimentally provide models of the mechanical behavior during DO of the BC exclusively. 34 By reproducing the same experimental model in BL cases, it would be possible to quantify the effects of ST in vivo. In this context, viscoelastic models of the mechanical behavior of the BC and ST would be very useful to have better control of the evolution of bone lengthening processes, to establish upper limits of BL, and to prevent short-term damages to patients.…”

Section: Introductionmentioning

confidence: 99%

Mechanical Influence of Surrounding Soft Tissue on Bone Regeneration Processes: A Bone Lengthening Study

et al. 2020

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Bone lengthening is a bone regeneration technique with multiple clinical applications. One of the most common complications of this treatment is the lack of adaptation of the surrounding soft tissue to their extension. A better understanding of the mechanobiology of the tissues involved in distraction osteogenesis would allow better control of the clinical cases. Bone lengthening treatments were performed in vivo in the metatarsus of Merino sheep, measuring the distraction forces by means of an instrumented fixator. The tissue relaxation after distraction was analyzed in this study. A viscoelastic model was also applied to distraction data to assess the mechanical behavior of the tissues during the distraction phase. Tissue relaxation is similar to other bone regeneration processes which do not imply surrounding soft tissue extension, e.g. bone transport. The effects of this tissue on distraction forces are limited to the first minutes of distraction and elongations above 4% of the original length with the protocol applied. Moreover, the surrounding soft tissue initially loses some of its viscoelasticity and subsequently suffers strain hardening from day 5 of distraction until the end of the distraction phase, day 15. Finally, anatomical changes were also evidenced in the elongated limb of our specimens.

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“…Homogeneous sets of elements that represent different tissue types (eg, medullar tissue and cortical bone soft and hard callus tissue) have been traditionally used in mechanobiological studies of distraction osteogenesis and bone healing while assigning constant properties to each set of elements . However, this approach uses a strong assumption since the mechanical properties of all tissue types within the callus increase during the distraction phase . Manual segmentation conducted in this study accounts for the variation in the mechanical properties of the hard callus tissue taken from experiments .…”

Section: Discussionmentioning

confidence: 99%

“…[27][28][29][30][31] However, this approach uses a strong assumption since the mechanical properties of all tissue types within the callus increase during the distraction phase. 1,13,38 Manual segmentation conducted in this study accounts for the variation in the mechanical properties of the hard callus tissue taken from experiments. 13,32 The proposed random distribution of the porosity and elastic modulus of woven FIGURE 6 Volume proportion of the soft and hard tissue within the callus from manual segmentation bone provides acceptable predictions of the callus stiffness compared with in vivo measurements and the assignment of mechanical properties according to the level of HU (Figure 7).…”

Section: Discussionmentioning

confidence: 99%

Comparison of methods for assigning the material properties of the distraction callus in computational models

Mora‐Macías

Giráldez‐Sánchez

López

et al. 2019

Numer Methods Biomed Eng

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In silico models of distraction osteogenesis and fracture healing usually assume constant mechanical properties for the new bone tissue generated. In addition, these models do not always account for the porosity of the woven bone and its evolution. In this study, finite element analyses based on computed tomography (CT) are used to predict the stiffness of the callus until 69 weeks after surgery using 15 CT images obtained at different stages of an experiment on bone transport, technique in which distraction osteogenesis is used to correct bone defects. Three different approaches were used to assign the mechanical properties to the new bone tissue. First, constant mechanical properties of the hard callus tissue and no porosity were assumed. Nevertheless, this approach did not show good correlations. Second, random variations in the elastic modulus and porosity of the woven bone were taken from previous experimental studies. Finally, the elastic properties of each element were assigned depending on gray scale in CT images. The numerically predicted callus stiffness was compared with previous in vivo measurements. It was concluded firstly that assignment depending on gray scale is the method that provides the best results and secondly that the method that considers a random distribution of porosity and elastic modulus of the callus is also suitable to predict the callus stiffness from 15 weeks after surgery. This finding provides a method for assigning the material properties of the distraction callus, which does not require CT images and may contribute to improve current in silico models.

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Model of the distraction callus tissue behavior during bone transport based in experiments in vivo

Cited by 20 publications

References 40 publications

Novel systems for the application of isolated tensile, compressive, and shearing stimulation of distraction callus tissue

Novel systems for the application of isolated tensile, compressive, and shearing stimulation of distraction callus tissue

Mechanical Influence of Surrounding Soft Tissue on Bone Regeneration Processes: A Bone Lengthening Study

Comparison of methods for assigning the material properties of the distraction callus in computational models

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