Fracture mechanics of bone with short cracks

Tensile fracture experiments were performed upon specimens of wet mature bovine Haversian bone, with short, controlled notches. Stress concentration factors were found to be significantly less than values predicted using a maximum stress criterion in the theory of elasticity. Results were also modeled with the aid of linear elastic fracture mechanics. Agreement of experiment with theory was better in this case, however deviations were seen for short notches. Two mechanisms were evaluated for the behavior: plasticity near the crack tip, and effects of the Haversian microstructure, modelled by Cosserat elasticity, a generalized continuum theory. Plastic zone effects were found to be insignificant. Cosserat elasticity, by contrast, predicted stress concentration factors which better approximated observed values. To explore strain redistribution processes, further experiments were conducted upon notched specimens in torsion at small strain. They disclosed a strain redistribution effect consistent with Cosserat elasticity. These microelastic effects were attributed to the Haversian architecture of bone. The implications of the results are that bone resists the effect of stress raisers such as fatigue microcracks and surgical sawcuts to a much greater extent than anticipated on the basis of its elastic or elastoplastic properties.     

Microscopic fracture aspects of impact tested human bones

The fracture aspects of impact twisted human femurs and tibias have been studied in their wet condition. The main tool used to correlate fracture behaviour with bone structure was the scanning electron microscope. Supplementary data were obtained from macroscopic fracture pattern analyses and stress coat experiments on slowly tested dried bone. The interest of the data reported concerns two major points. Firstly the analysis of the fractographic results leads to the conclusion that the fracture has presumably been initiated by shearing parallel with the torsion axis. The fracture propagates along so called spiral and oblique fracture lines. Secondly, the correlation of the macroscopic fracture pattern with microscopic fracture aspects indicates that the fracture is initiated along the cement lines, which can be considered as the weak matrix in an osteon-cement lining composite. The fracture propagates along the cement lines as well as through osteons and lamellae. Throughout the impact fracture surfaces ductile and brittle fracture aspects were observed, although the brittle fracture mode was predominant during propagation.     

Tensile fatigue failure of acrylic bone cement

Tensile fatigue tests of acrylic bone cement were conducted under strain control in a wet environment at 37 degrees C. A constant strain rate of 0.02s-1 was used, resulting in physiologic loading frequencies. Comparison of the tensile fatigue data with the results of previous tension-compression fatigue tests indicates that fatigue failure is governed primarily by the maximum cyclic tensile strain. The compressive portion of the loading cycle has little effect on the number of cycles to failure. A new empirically derived equation is introduced to describe the influence of mean strain and strain amplitude on fatigue endurance. The results emphasize the critical role tensile strains may play in cement failure and loosening of total joint replacements.     

Interfacial Strength of Cement Lines in Human Cortical Bone

In human cortical bone, cement lines (or reversal lines) separate osteons from the interstitial bone tissue, which consists of remnants of primary lamellar bone or fragments of remodeled osteons. There have been experimental evidences of the cement line involvement in the failure process of bone such as fatigue and damage. However, there are almost no experimental data on interfacial properties of cement lines in human cortical bone. The objective of this study is to design and assemble a precision and computer controlled osteon pushout microtesting system, and to experimentally determine the interfacial strength of cement lines in human cortical bone by performing osteon pushout tests. Thirty specimens were prepared from humeral diaphyses of four human subjects. Twenty specimens were tested under the condition of a small hole in the supporting plate, in which the cement line debonding occurred. The cement line interfacial strength ranged from 5.38 MPa to 10.85 MPa with an average of 7.31±1.73 MPa. On the other hand, ten specimens were tested under the condition of a large hole in the supporting plate, in which the shear failure inside osteons was observed. The specimens tested under the condition of the large hole resulted in an average shear strength of 73.71±15.06 MPa, ranging from 45.97 MPa to 93.74 MPa. Therefore, our results suggest that the cement line interface between osteon and interstitial bone tissue is weaker than that between bone tissue lamellae.     

Influence of the change in stem length on the load transfer and bone remodelling for a cemented resurfaced femur

The effect of a short-stem femoral resurfacing component on load transfer and potential failure mechanisms has rarely been studied. The stem length has been reduced by approximately 50% as compared to the current long-stem design. Using 3-D FE models of natural and resurfaced femurs, the study is aimed at investigating the influence of a short-stem resurfacing component on load transfer and bone remodelling. Applied loading conditions include normal walking and stair climbing. The mechanical role of the stem along with implant–cement and stem–bone contact conditions was observed to be crucial. Shortening the stem length to half of the current length (long-stem) led to several favourable effects, even though the stress distributions in the implant and the cement were similar in both the cases. The short-stem implant led not only to a more physiological stress distribution but also to bone apposition (increase of 20–70% bone density) in the superior resurfaced head, when the stem–bone contact prevailed. This also led to a reduction in strain concentration in the cancellous bone around the femoral neck–component junction. The normalised peak strain in this region was lower for the short-stem design as compared to that of the long-stem one, thereby reducing the initial risk of neck fracture. The effect of strain shielding (50–75% reduction) was restricted to a small bone volume underlying the cement, which was approximately half of that of the long-stem design. Consequently, bone resorption was considerably less for the short-stem design. The short-stem design offers better prospects than the long-stem resurfacing component.     

The mechanical characteristics of cancellous bone at the upper femoral region

Mechanical behaviour of trabecular bone at the upper femoral region of human bones has been studied by compression tests on trabecular bone specimens removed from normal femora obtained at autopsy. Compression tests were performed along three different axes of loading on wet specimens and high loading rates. Femoral head specimens proved to be the strongest for any axis of loading.

Large variation in compressive strength and modulus of elasticity is seen within and between femoral bone samples. Anisotropy and differences in anisotropy for the different regions have been observed. A significant correlation between mechanical properties (σ max − E) and bone mineral content of the specimen was found.

Tests on whole bone structures demonstrate that removal of the central part of the trabecular bone at the proximal femur reduces the strength for impact loading considerably (± 50%).     

A new standard method for experimental for measuring cement coat strength in endoprosthesis implantation]

The distribution of bone cement around an endoprosthesis influences its stability over the long term. We have developed a new method for the experimental measurement of the cement mantle thickness of an endoprosthesis. The use of this computer-aided procedure is described in a hip prosthesis. Transverse sections of a human femur containing a cemented stem were prepared, recorded with a CCD camera and the images fed into a computer. The image-processing software differentiated the metal and bone cement on the basis of the different colours. Radial lines were drawn from the calculated centre of gravity of the stem, and the cement thickness was measured automatically along these lines. In our experiment, the accuracy of the method was 0.2 mm. This method of measuring the thickness of the cement mantle is accurate, rapid and practical.     

The mechanical behaviour of intracondylar cancellous bone of the femur at different loading rates

The compressive properties of human cancellous bone of the distal intracondylar femur in its wet condition were determined. Specimens were obtained from six cadaveric femora and were tested at a strain rate of 0.002, 0.10 and 9.16 sec⁻¹. It was found that the compressive strength decreases with an increasing vertical distance from the joint. The highest compressive strength level was recorded in the posterior medial condyle. Correlations among the mechanical properties, the bulk specimen density and the bone mineral content yield (i) highly significant correlations between the compressive strength and the elastic modulus (ii) highly significant correlations between the compressive strength or the modulus of elasticity and the bulk specimen density (iii) a doubtful correlation between the compressive strength and the bone mineral content. All recorded graphs of the impact loaded specimens displayed several well defined stress peaks, unlike the graphs recorded at low loading rates. It can be concluded that upon impact loading the localized trabecular failure which is associated with each peak, does not affect the spongy bone's stress capacity in a detrimental way.     

Calcium phosphate cement augmentation of cancellous bone screws can compensate for the absence of cortical fixation

An obvious means to improve the fixation of a cancellous bone screw is to augment the surrounding bone with cement. Previous studies have shown that bone augmentation with Calcium Phosphate (CaP) cement significantly improves screw fixation. Nevertheless, quantitative data about the optimal distribution of CaP cement is not available. The present study aims to show the effect of cement distribution on the screw fixation strength for various cortical thicknesses and to determine the conditions at which cement augmentation can compensate for the absence of cortical fixation in osteoporotic bone. In this study, artificial bone materials were used to mimic osteoporotic cancellous bone and cortical bone of varying thickness. These bone constructs were used to test the fixation strength of cancellous bone screws in different cortical thicknesses and different cement augmentation depths. The cement distribution was measured with microCT. The maximum pullout force was measured experimentally. The microCT analysis revealed a pseudo-conic shape distribution of the cement around the screws. While the maximum pullout strength of the screws in the artificial bone only was 30±7 N, it could increase up to approximately 1000 N under optimal conditions. Cement augmentation significantly increased pullout force in all cases. The effect of cortical thickness on pullout force was reduced with increased cement augmentation depth. Indeed, cement augmentation without cortical fixation increased pullout forces over that of screws without cement augmentation but with cortical fixation. Since cement augmentation significantly increased pullout force in all cases, we conclude that the loss of cortical fixation can be compensated by cement augmentation.     

Design considerations for ceramic resurfaced femoral head: effect of interface characteristics on failure mechanisms

Ceramic hip resurfacing may offer improved wear resistance compared to metallic components. The study is aimed at investigating the effects of stiffer ceramic components on the stress/strain-related failure mechanisms in the resurfaced femur, using three-dimensional finite element models of intact and resurfaced femurs with varying stem–bone interface conditions. Tensile stresses in the cement varied between 1 and 5 MPa. Postoperatively, 20–85% strain shielding was observed inside the resurfaced head. The variability in stem–bone interface condition strongly influenced the stresses and strains generated within the resurfaced femoral head. For full stem–bone contact, high tensile (151–158 MPa) stresses were generated at the cup–stem junction, indicating risk of fracture. Moreover, there was risk of femoral neck fracture due to elevated bone strains (0.60–0.80% strain) in the proximal femoral neck region. Stresses in the ceramic component are reduced if a frictionless gap condition exists at the stem–bone interface. High stresses, coupled with increased strain shielding in the ceramic resurfaced femur, appear to be major concerns regarding its use as an alternative material.     

Residual stress due to curing can initiate damage in porous bone cement: experimental and theoretical evidence

Residual stress due to shrinkage of polymethylmethacrylate bone cement after polymerisation is possibly one factor capable of initiating cracks in the mantle of cemented hip replacements. No relationship between residual stress and observed cracking of cement has yet been demonstrated. To investigate if any relationship exists, a physical model has been developed which allows direct observation of damage in the cement layer on the femoral side of total hip replacement. The model contains medial and lateral cement layers between a bony surface and a metal stem; the tubular nature of the cement mantle is ignored. Five specimens were prepared and examined for cracking using manual tracing of stained cracks, observed by transmission microscopy; cracks were located and measured using image analysis. A mathematical approach for the prediction of residual stress due to shrinkage was developed which uses the thermal history of the material to predict when stress-locking occurs, and estimates subsequent thermal stress. The residual stress distribution of the cement layer in the physical model was then calculated using finite element analysis. Results show maximum tensile stresses normal to the observed crack directions, suggesting a link between residual stress and pre-load cracking. The residual stress predicted depends strongly on the definition of the reference temperature for stress-locking. The highest residual stresses (4-7 MPa) are predicted for shrinkage from maximum temperature; in this case, magnitudes are sufficiently high to initiate cracks when the influence of stress raisers such as pores or interdigitation at the bone/cement interface are taken into account (up to 24 MPa when calculating stress around a pore according to the method of Harrigan and Harris (J. Biomech. 24(11) (1991) 1047-1058). We conclude that the damage accumulation failure scenario begins before weight-bearing due to cracking induced by residual stress around pores or stress raisers.     

骨水泥凝固前有无血液环境对骨水泥与骨界面稳定性的影响

目的:研究在有血和无血环境下粘合骨水泥和骨,比较两种粘合骨水泥的方式对骨与骨水泥界面稳定性影响的区别。方法:选取新鲜猪肱骨头20块,随机分成两组:实验组在有血的环境下用骨水泥将股骨头与金属粘合;对照组在无血的环境下用骨水泥将肱骨头和金属粘合,再将两组实验材料分别做拉伸试验,至骨与骨水泥界面断裂,最后再沿垂直于截骨面的方向做骨切片,在扫描电镜下观察并测量出每个实验对象中骨水泥的最大浸润深度。比较两组实验过程中拉力的最大载荷和断裂时的拉力以及骨水泥最大浸润深度。结果:实验组10个实验对象拉力最大载荷平均为738.50±262.15 N,断裂时的拉力平均为656.50±242.88N,骨水泥最大浸润深度平均为1.22±0.19 MM;对照组10个实验对象实验过程中拉力最大载平均为739.60±306.98 N,断裂时的拉力平均为658.80±264.56 N,骨水泥最大浸润深度平均为1.22±0.21 MM。20个实验对象在实验过程中均无意外断裂的情况发生,均在骨与骨水泥界面发生断裂。两组实验的拉力最大载荷与断裂拉力以及骨水泥最大浸润深度,均无统计学差异(P0.05)。结论:血液环境不能增加骨与骨水泥界面的不稳定因素。因此,与应用止血带相比,在TKA手术中不用止血带可能不会对骨与骨水泥界面稳定性和假体的寿命产生影响。     

Geometric determinants to cement line debonding and osteonal lamellae failure in osteon pushout tests

Cement lines are the boundaries between secondary osteons and the surrounding interstitial bone matrix in cortical bone. The interfacial properties of cement lines have been determined by osteon pushout tests. However, distinctively different material properties were obtained when osteon pushout tests were performed under different test geometries. In the present study, an axisymmetric two-dimensional finite element model was used to simulate an osteon pushout test using the test geometry of actual experiments. The results indicated that shear failure within the osteonal lamellae would occur when the osteon pushout test was performed under the condition of a thick specimen and large supporting hole. On the other hand, cement line debonding occurred when the osteon pushout test was performed using a thin specimen and small supporting hole. The finite element results were consistent with previous experiments of osteon pushout tests under different test geometries. Furthermore, the finite-element results suggest that a smoothly curved punch would most likely cause debonding at the cement line instead of osteonal lamellae.     

The effect of Haversian remodeling on the tensile properties of human cortical bone

The purpose of this study was to determine the effect of Haversian remodeling on the tensile properties of human cortical bone by testing specimens containing, as far a possible, a single type of bone tissue. Fifty-one specimens were prepared from sixteen fresh tibias, removed at autopsy. Age range was 19-35. Regions were selected so that the specimens would consist almost exclusively of either primary bone or Haversian bone. The ultimate tensile strength, ultimate strain and Young's modulus of elasticity were determined at a loading rate of 0.05 mm s-1. The primary bone specimens were found to have a significantly higher ultimate tensile strength and modulus of elasticity than those formed of Haversian bone.     

Negative Poisson ratio of crystalline cellulose in kraft cooked Norway spruce

The tensile properties of kraft cooked Norway spruce were studied by tensile testing with in situ X-ray diffraction (XRD). Samples were of earlywood, cooked for varying times. The total lignin content of the samples was between 21.7% and 9.3%. Tensile tests with XRD were performed on wet samples, without XRD on dry samples. The tensile strength, the modulus of elasticity (MOE), and the elongation at fracture/yield were determined. X-ray diffraction was used to determine the microfibril angle (MFA) and the deformation of crystalline cellulose by monitoring the reflections 200 and 004. The (X-ray) Poisson ratio of crystalline cellulose was calculated, both before and after the yield point. The tensile strength and the MOE of the wet samples were significantly lower than in the dry samples. The tensile properties of dry samples were similar to dry earlywood samples of untreated Norway spruce. The MFA only showed notable changes due to strain when it was initially large, when a diminishing effect was observed. The Poisson ratio of crystalline cellulose was negative. The average values ranged between -0.26 and -1.17 before the yield point and between -0.86 and -1.05 after the yield point.     

The influence of cement mantle thickness and stem geometry on fatigue damage in two different cemented hip femoral prostheses

Experimental models can be used for pre-clinical testing of cemented and other type of hip replacements. Total hip replacement (THR) failure scenarios include, among others, cement damage accumulation and the assessment of accurate stress and strain magnitudes at the cement mantle interfaces (stem-cement and cement-bone) can be used to predict mechanical failure. The aseptic loosening scenario in cemented hip replacements is currently not fully understood, and methods of evaluating medical devices must be developed to improve clinical performance. Different results and conclusions concerning the cement micro-cracking mechanism have been reported.The aim of this study was to verify the in vitro behavior of two cemented femoral stems with respect to fatigue crack formation. Fatigue crack damage was assessed at the medial, lateral, anterior and posterior sides of the Lubinus SPII and Charnley stems. All stems were loaded and tested in stair climbing fatigue loading during one million cycles at 2 Hz. After the experiments each implanted synthetic femur was sectioned and analyzed. We observed more damage (cracks per area) for the Lubinus SPII stem, mainly on the proximal part of the cement mantle. The micro-cracking formation initiated in the stem–cement interface and grew towards the direction of cortical bone of the femur.Overall, the cement–bone interface seems to be crucial for the success of the hip replacement. The Charnley stem provoked more damage on the cement–bone interface. A failure index (maximum length of crack/maximum thickness of cement) considered was higher for the cement–stem interface of the Lubinus SPII stem. For a cement mantle thickness higher than 5 mm, cracking initiated at the cement–bone interface and depended on the opening canal process (reaming procedure and instrumentation). The analysis also showed that fatigue-induced damage on the cement mantle, increasing proximally, and depended on the axial position of the stem. The cement thickness is an important factor for the success of THR and this study evidenced that cement thickness higher than 2 mm apparently does not affect the mechanical behavior of the cement mantel and induce more crack formation on the cement–bone interface.     

A theoretical model to predict distribution of the fabric tensor and apparent density in cancellous bone

 The adaptation of cancellous bone to mechanical forces is well recognized. Theoretical models for predicting cancellous bone architecture have been developed and have mainly focused on the distribution of trabecular mass or the apparent density. The purpose of this study was to develop a theoretical model which can simultaneously predict the distribution of trabecular orthotropy/orientation, as represented by the fabric tensor, along with apparent density. Two sets of equations were derived under the assumption that cancellous bone is a biological self-optimizing material which tends to minimize strain energy. The first set of equations provide the relationship between the fabric tensor and stress tensor, and have been verified to be consistent with Wolff’s law of trabecular architecture, that is, the principal directions of the fabric tensor coincide with the principal stress trajectories. The second set of equations yield the apparent density from the stress tensor, which was shown to be identical to those obtained based on local optimization with strain energy density of true bone tissue as the objective function. These two sets of equations, together with elasticity field equations, provide a complete mathematical formulation for the adaptation of cancellous bone. Received: 25 February 1997/Revised version: 23 September 1997     

骨质疏松椎体压缩性骨折患者经皮椎体成形术后再次骨折的危险因素分析

目的:探讨骨质疏松椎体压缩骨折患者接受椎体成形术后再次新发骨折的危险因素。方法:选取2009年1月到2015年1月就诊于我院诊断为骨质疏松椎体压缩性骨折且行经皮椎体成形术的患者,收集患者的诊疗信息及影像学资料。收集患者的年龄、性别等基本资料及基于定量CT测量的骨矿物含量、骨水泥注射占椎体体积的比、骨水泥的分布及骨水泥的渗漏情况。将单椎体骨折且在随访时间内再次新发椎体骨折的患者分为A组,未骨折的患者分为B组,对比分析两组之间的参数的差异,并利用二项Logistic回归分析分析再次骨折的危险因素。结果:共有287例患者纳入研究,平均随访时间为34.7±17.8个月,压缩性骨折最常见的椎体依次为L1(29.1%)、T12(20.8%)及L2(13.5%)。在随访时间内共有32例患者再次发生椎体骨折。252例单椎体骨折患者中,26例(A组)再次发生骨折,226例(B组)未发生骨折。A组骨矿物含量低于B组(P0.001),骨水泥分布较B组差(P0.001),年龄高于B组(P0.001)且骨水泥渗漏发生率(34.6%)高于B组(13.7%)(P=0.006),两组在骨水泥占椎体的比、后凸程度、性别比例没有统计学差异。回归分析显示骨矿物含量(OR=1.092,P0.001)、年龄(OR=1.091,P0.001)及骨水泥渗漏(OR=1.200,P=0.002)均是再次骨折的危险因素,骨水泥的均匀分布是保护因素(OR=0.922,P0.001)。结论:年龄较大且骨质较差的患者容易再次发生椎体骨折,在行椎体成形术过程中应尽量使骨水泥均匀分布并避免骨水泥的渗漏。     

Microwave irradiation of ethanol-fixed bone improves preservation, reduces processing time, and allows both light and electron microscopy on the same sample.

Methylmethacrylate (MMA) embedding is routinely used for histomorphometry of undecalcified bone preserved by prolonged immersion in ethanol, a procedure that yields poor ultrastructural detail. Because microwave irradiation (MWI) facilitates penetration of fixatives, we have investigated whether it can improve preservation by ethanol. Rat tibiae, some labeled with tetracycline, and a human iliac crest biopsy were immersed in 70% ethanol and dehydrated, both under MWI, for a total processing time of approximately 7 hr. Controls were not irradiated, and all specimens were embedded in MMA at 4C. They were then processed for histomorphometry, histochemistry, structural analysis, and immunolabeling. The results showed that histological preservation was improved with MWI. Static bone formation and resorption parameters and rate of mineral apposition were similar to those of conventionally processed specimens. Mineral distribution, as visualized by von Kossa staining and backscattered electron imaging, was not affected. Alkaline phosphatase and tartrate-resistant acid phosphatase activity, as well as immunolocalization of bone sialoprotein and osteopontin, were readily visualized. Ultrastructurally, osteopontin exhibited a typical distribution in mineralization foci, between calcified collagen fibrils, and at cement lines. These data show that MWI improves preservation and permits application of a broad spectrum of analytical methodologies on the same bone sample while considerably reducing processing time.     

Human bone contains type III collagen, type VI collagen, and fibrillin: type III collagen is present on specific fibers that may mediate attachment of tendons, ligaments, and periosteum to calcified bone cortex

We evaluated the distribution of Type III collagen, Type VI collagen, and fibrillin in human bone, using monoclonal antibodies (MAb) of proven specificity. All three molecules are present in developing and remodeling bone. Type III collagen is present in discrete fiber bundles throughout the bone cortex but is concentrated at the Haversian canal surface and in the fibers at the bone-periosteal interface. The collagen fibrils in these bundles are of uniform diameter. Type III-containing collagen fibers are detected at all ages examined, from 30 fetal weeks to 80 years. Type VI collagen is present in fetal bone in discrete fibrils separate from Type III collagen, and becomes restricted to the margins of bone cells and the bone surface by 7 years. The distribution of fibrillin resembles that of Type III collagen in the fetus, but at 7 years is absent from the interior of the cortex except for the canaliculi and cement lines, and remains concentrated in discrete fibers at the bone surface.