Skeletal Microdamage: Less About Biomechanics and More About Remodeling

Allen, Matthew R.; Burr, David B.

doi:10.1007/s12018-008-9015-5

Cited by 38 publications

(20 citation statements)

References 54 publications

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“…The potential detrimental role of accumulated damage due to aging and long-term administration of anti-resorptive drugs remains a clinical concern (Allen and Burr 2008). Quantification of the relative roles of damage, density, and architecture are needed to determine the balance between the positive effects of these treatments on density and architecture (Black et al 1996; Fogelman et al 2000; Reid et al 2002; Dufresne et al 2003; Recker et al 2004) vs. the detrimental effects of accumulated microdamage (Mashiba et al 2000; Mashiba et al 2001b) and bone loss due to aging.…”

Section: Discussionmentioning

confidence: 99%

Shear strength and toughness of trabecular bone are more sensitive to density than damage

Garrison

Gargac

Niebur

2011

Journal of Biomechanics

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Microdamage occurs in trabecular bone under normal loading, which impairs the mechanical properties. Architectural degradation associated with osteoporosis increases damage susceptibility, resulting in a cumulative negative effect on the mechanical properties. Treatments for osteoporosis could be targeted toward increased bone mineral density, improved architecture, or repair and prevention of microdamage. Delineating the relative roles of damage and architectural degradation on trabecular bone strength will provide insight into the most beneficial targets. In this study, damage was induced in bovine trabecular bone samples by axial compression, and the effects on the mechanical properties in shear were assessed. The damaged shear modulus, shear yield stress, ultimate shear stress, and energy to failure all depended on induced damage and decreased as the architecture became more rod-like. The changes in ultimate shear strength and toughness were proportional to the decrease in shear modulus, consistent with an effective decrease in the cross-section of trabeculae based on cellular solid analysis. For typical ranges of bone volume fraction in human bone, the strength and toughness were much more sensitive to decreased volume fraction than to induced mechanical damage. While ultimately repairing or avoiding damage to the bone structure and increasing bone density both improve mechanical properties, increasing bone density is the more important contributor to bone strength.

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Section: Discussionmentioning

confidence: 99%

Shear strength and toughness of trabecular bone are more sensitive to density than damage

Garrison

Gargac

Niebur

2011

Journal of Biomechanics

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“…It is now well established in animal models that the suppression of remodeling allows microdamage accumulation [36,[50][51][52], and that this is not necessarily a BP-specific effect [53].…”

Section: Bps and Microdamage -What We Know (Table 2)mentioning

confidence: 99%

Bisphosphonate effects on bone turnover, microdamage, and mechanical properties: What we think we know and what we know that we don't know

Allen

Burr

2011

Bone

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195

159

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This is the author's manuscript of the article published in final edited form as: Allen M. R., Burr D.B. (2011 A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT AbstractThe bisphosphonates (BPs) have been useful tools in our understanding of the role that bone remodeling plays in skeletal health. The purpose of this paper is to outline what we know, and what is still unknown, about the role that BPs play in modulating bone turnover, how this affects microdamage accumulation, and ultimately what the effects of these changes elicited by BPs are to the structural and the material biomechanical properties of the skeleton. We know thatBPs suppress remodeling site-specifically, probably do not have a direct effect on formation, and that the individual BPs vary with respect to speed of onset, duration of effect and magnitude of suppression. However, we do not know if these differences are meaningful in a clinical sense, how much remodeling is sufficient, the optimal duration of treatment, or how long it takes to restore remodeling to pre-treatment levels. We also know that suppression is intimately tied to microdamage accumulation, which is also site-specific, that BPs impair targeted repair of damage, and that they can reduce the energy absorption capacity of bone at the tissue level.However, the BPs are clearly effective at preventing fracture, and generally increase bone mineral density and whole bone strength, so we do not know whether these changes in damage accumulation and repair, or the mechanical effects at the tissue level, are clinically meaningful.The mechanical effects of BPs to the fatigue life of bone, or BP effects on bone subject to an impact, are entirely unknown. This paper reviews the literature on these topics, and identifies gaps in knowledge that can be addressed with further research.

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“…In clinical trials, typically of a duration of less than 5 yr, antiresorptives decrease the risk of classical osteoporotic fractures, but it is unclear whether retention of old, less mechanically competent bone tissue could affect mechanical properties in the long term (2)(3)(4). In some cases, atypical fractures were seen in patients treated for less than 2 yr and thus well within the duration of the original phase III trials (5)(6)(7).…”

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confidence: 99%

Cumulative Alendronate Dose and the Long-Term Absolute Risk of Subtrochanteric and Diaphyseal Femur Fractures: A Register-Based National Cohort Analysis

Abrahamsen

Eiken²,

Eastell

2010

The Journal of Clinical Endocrinology & Metabolism

143

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Skeletal Microdamage: Less About Biomechanics and More About Remodeling

Cited by 38 publications

References 54 publications

Shear strength and toughness of trabecular bone are more sensitive to density than damage

Shear strength and toughness of trabecular bone are more sensitive to density than damage

Bisphosphonate effects on bone turnover, microdamage, and mechanical properties: What we think we know and what we know that we don't know

Cumulative Alendronate Dose and the Long-Term Absolute Risk of Subtrochanteric and Diaphyseal Femur Fractures: A Register-Based National Cohort Analysis

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