One mechanostat or many? Modifications of the site-specific response of bone to mechanical loading by nature and nurture

The concept of the mechanostat was not new in 1983, when Harold Frost coined the term to describe a mechanism by which bone responded to habitual exercise and changes in loading with structurally appropriate alterations in bone architecture. However, the word "mechanostat" has a meaning that is immediately apparent, and its adoption has led to a much wider appreciation of the process of functional adaptation by other scientists than those whose primary research focus is in the biology of adaptation. One problem exists though: it is widely thought that in a single individual, there is a setting for the mechanostat, just as a single thermostat might set the temperature for a whole house, and this is reflected in the idea that bones throughout the skeleton require a specific strain magnitude for maintenance. Increases in loading above that threshold are expected to induce bone formation and a stiffer structure that then experiences again the habitual strain magnitude. Reductions in strain magnitude supposedly induce resorption to reduce tissue mass and architectural properties so that the lower loading restores habitual strain magnitude. That widely held belief of a single unifying number of strain is fundamentally flawed. The purpose of this article is to explain the real basis of the mechanostat; that the skeleton responds to a complex strain stimulus, made up of numerous different parameters, of which peak magnitude is only one, and that the strain stimulus is different in different parts of the skeleton, so there is no universal number to describe a tissue strain magnitude that underlies the mechanostat's setting. Furthermore, males and females have different responses to loading, and those responses change in response to many factors including genetic constitution, age, concomitant disease, nutrient availability, and exposure to drugs or biochemicals. In summary then, there is not a single mechanostat controlling the skeleton of each of us. At a fundamental tissue level, small functional units of bone each have their own multifactorial threshold target strain stimuli for a given set of dynamic modifying influences. Understanding the biology behind the way that each of these mechanostats functions independently is likely to have pervasive consequences on our ability to control bone mass by manipulation of loading, either directly through different exercise regimens, or in a targeted manner using tailored site and individual specific pharmaceuticals.     

Changes in bone mineral density and microarchitecture in cosmonauts after a six-month space flight

The effect of microgravity on the bone tissue of cosmonauts has been studied after a six-month space flight. The volumetric bone mineral density (VBMD) and the bone structural characteristics of distal segments in the radius and tibia have been studied by means of peripheral quantitative computed tomography (pQCT). The changes in VBMD were found to correlate with the position of the bone relative to the vector of gravity. In the radius, reversible hypermineralization, together with thickening of the compact bone were recorded. In the tibia, reversible osteopenia was characterized by significant losses in both compact and trabecular bones. Irrespective of the position relative to the vector of gravity, there was a trend towards microarchitectural deterioration, such as a decrease in the trabecula number and increase in the bone tissue heterogeneity. Postflight dynamics of structural parameters showed an integrative character with nonlinear time dependence.     

Densitometric and tomographic analyses of musculoskeletal interactions in humans

Previous studies with standard densitometry (DXA) have suggested that the bone mass is strongly dependent on the muscle mass in the species, following a similar relationship at any age and sex hormones or related factors potentiate that relationship. Studies with pQCT indicated that the surplus bone mass per unit of muscle mass previously observed in premenopausal women would be stored in skeletal regions with relatively little mechanical relevance, thus avoiding remotion through mechanically oriented remodelling by the bone mechanostat. Scanning the distal radius with pQCT has also showed a highly significant, linear relationship between SSI of the distal radius and the dynamometric maximal bending moment of the forearm in normal men and women. In order to investigate similar relationships in regions that are inaccessible to pQCT, we used spinal radiographs and axial QCT. This study affords additional evidence to the previous references concerning the direct, significant impact of the regional muscle strength on the determination of the tomographic indicators of bone mechanical quality and their indirect repercussion of the skeletal condition (curvature of the spine).     

Patterns of strain in the macaque tibia during functional activity.

The strain environment of the tibial midshaft of two female macaques was evaluated through in vivo bone strain experiments using three rosette gauges around the circumference of the bones. Strains were collected for a total of 123 walking and galloping steps as well as several climbing cycles. Principal strains and the angle of the maximum (tensile) principal strain with the long axis of the bone were calculated for each gauge site. In addition, the normal strain distribution throughout the cross section was determined from the longitudinal normal strains (strains in the direction of the long axis of the bone) at each of the three gauge sites, and at the corresponding cross-sectional geometry of the bone. This strain distribution was compared with the cross-sectional properties (area moments) of the midshaft. For both animals, the predominant loading regime was found to be bending about an oblique axis running from anterolateral to posteromedial. The anterior and part of the medial cortex are in tension; the posterior and part of the lateral cortex are in compression. The axis of bending does not coincide with the maximum principal axis of the cross section, which runs mediolaterally. The bones are not especially buttressed in the plane of bending, but offer the greatest strength anteroposteriorly. The cross-sectional geometry therefore does not minimize strain or bone tissue. Peak tibial strains are slightly higher than the peak ulnar strains reported earlier for the same animals (Demes et al. [1998] Am J Phys Anthropol 106:87-100). Peak strains for both the tibia and the ulna are moderate in comparison to strains recorded during walking and galloping activities in nonprimate mammals.     

Modeling and remodeling responses to normal loading in the human lower limb

Limb bones are designed to be strong enough to support the body and yet be energetically conservative during locomotion. Bones of the distal segment, which are relatively costly to move, are often more slender than bones of the proximal segments, even though they must sustain proportionally greater loads. As a result, they are expected to experience a higher incidence of microdamage. With this constraint in mind, Lieberman and Crompton (1998 Principles of Animal Design, Cambridge: Cambridge University Press, p. 78-86) proposed that bones response to strain varies along the proximo-distal axis of the limb. In order to avoid fatigue fractures due to the accumulation of microdamage, the distal segment, in comparison to the proximal segment, will have an increase in remodeling events to replace damaged bone. In this paper, we test the hypothesis of Lieberman and Crompton (1998) with respect to the human lower limb. With a sample of adult individuals, we compare tibiae and femora for mid-diaphyseal cross-sectional geometry and Haversian remodeling differences. Our results indicate that the human limb is not designed like that of quadrupedal cursorial animals. The tibia is not less resistant in bending and torsion, and does not remodel more than the femur. Our findings fail to support the hypothesis of Lieberman and Crompton (1998) and suggest, instead, that the human lower limb is not designed like a cursorial animal limb. In addition, our results support previous observations that remodeling is not uniform within the cross section of a bone, probably a reflection of different loading histories within the different regions of the cross section.     

Overview: animal models of osteopenia and osteoporosis

Prior to initiating a clinical trial in a post-menopausal osteoporosis study, it is reasonable to recommence the evaluation of treatment in the 9-month-old ovariectomized female rat. A female rat of this age has reached peak bone mass and can be manipulated to simulate clinical findings of post-menopausal osteoporosis. Ample time exists for experimental protocols that either prevent estrogen depletion osteopenia or restore bone loss after estrogen depletion. More time can be saved by acceleration of the development of the osteopenia by combining ovariectomized (OVX) plus immobilization (IM) models. Methods like serum biochemistry, histomorphometry and densitometry used in humans are applicable in rats. Like most animal models of osteopenia, the rat develops no fragility fractures, but mechanical testing of rat bones substitutes as a predictor of bone fragility. Recent studies have shown that the prevailing activity in cancellous and cortical bone of the sampling sites in rats is remodeling. The problems of dealing with a growing skeleton, the site specificity of the OVX and IM models, the lack of trabecular and Haversian remodeling and the slow developing cortical bone loss have been and can be overcome by adding beginning and pre-treatment controls and muscle mass measurements in all experimental designs, selecting cancellous bone sampling sites that are remodeling, concentrating the analysis of cortical bone loss to the peri-medullary bone and combining OVX and IM in a model to accelerate the development of both cancellous and cortical bone osteopenia. Not to be forgotten is the distal tibia site, an adult bone site with growth plate closure at 3 months and low trabecular bone turnover and architecture similar to human spongiosa. This site would be most challenging to the action of bone anabolic agents. Data about estrogen-deplete mice are encouraging, but the ovariectomized rat model suggests that developing an ovariectomized mouse model as an alternative is not urgent. Nevertheless, the mouse model has a place in drug development and skeletal research. In dealing with drug development, it could be a useful model because it is a much smaller animal requiring fewer drugs for screening. In skeletal research mice are useful in revealing genetic markers for peak bone mass and gene manipulations that affect bone mass, structure and strength. When the exciting mouse glucocorticoid-induced bone loss model of Weinstein and Manolagas is confirmed by others, it could be a significant breakthrough for that area of research. Lastly, we find that the information generated from skeletal studies of nonhuman primates has been most disappointing and recommend that these expensive skeletal studies be curtailed unless it is required by a regulatory agency for safety studies.     

Experimental and finite element analysis of the rat ulnar loading model-correlations between strain and bone formation following fatigue loading

The rat forelimb compression model has been used widely to study bone response to mechanical loading. We used strain gages to assess load sharing between the ulna and radius in the forelimb of adult Fisher rats. We used histology and peripheral quantitative computed tomography (pQCT) to quantify ulnar bone formation 12 days after in vivo fatigue loading. Lastly, we developed a finite element model of the ulna to predict the pattern of surface strains during compression. Our findings indicate that at the mid-shaft the ulna carries 65% of the applied compressive force on the forelimb. We observed large variations in fatigue-induced bone formation over the circumference and length of the ulna. Bone formation was greatest 1-2 mm distal to the mid-shaft. At the mid-shaft, we observed woven bone formation that was greatest medially. Finite element analysis indicated a strain pattern consistent with a compression-bending loading mode, with the greatest strains occurring in compression on the medial surface and lesser tensile strains occurring laterally. A peak strain of -5190 microepsilon (for 13.3N forelimb compression) occurred 1-2 mm distal to the mid-shaft. The pattern of bone formation in the longitudinal direction was highly correlated to the predicted peak compressive axial strains at seven cross-sections (r2 = 0.89, p = 0.014). The in-plane pattern of bone formation was poorly correlated to the predicted magnitude of axial strain at 51 periosteal locations (r2 = 0.21, p < 0.001), because the least bone formation was observed where tensile strains were highest. These findings indicate that the magnitude of bone formation after fatigue loading is greatest in regions of high compressive strain.     

Characterizing gait induced normal strains in a murine tibia cortical bone defect model

The critical role that mechanical stimuli serve in mediating bone repair is recognized but incompletely understood. Further, previous attempts to understand this role have utilized application of externally applied mechanical loads to study the tissue’s response. In this project, we have therefore endeavored to capitalize on bone’s own consistently diverse loading environment to develop a novel model that would enable assessment of the influence of physiologically engendered mechanical stimuli on cortical defect repair. We used an inverse dynamics approach with finite element analysis (FEA) to first quantify normal strain distributions generated in mouse tibia during locomotion. The strain environment of the tibia, as previously reported for other long bones, was found to arise primarily due to bending and was consistent in orientation through the stance phase of gait. Based on these data, we identified three regions within a transverse cross-section of the mid-diaphysis as uniform locations of either peak tension, peak compression, or the neutral axis of bending (i.e. minimal strain magnitude). We then used FEA to quantify the altered strain environment that would be produced by a 0.6 mm diameter cylindrical cortical bone defect at each diaphyseal site and, in an in situ study confirmed our ability to accurately place defects at the desired diaphyseal locations. The resulting model will enable the exploration of cortical bone healing within the context of physiologically engendered mechanical strain.     

A full body musculoskeletal model based on flexible multibody simulation approach utilised in bone strain analysis during human locomotion

Load-induced strains applied to bone can stimulate its development and adaptation. In order to quantify the incident strains within the skeleton, in vivo implementation of strain gauges on the surfaces of bone is typically used. However, in vivo strain measurements require invasive methodology that is challenging and limited to certain regions of superficial bones only such as the anterior surface of the tibia. Based on our previous study [Al Nazer et al. (2008) J Biomech. 41:1036-1043], an alternative numerical approach to analyse in vivo strains based on the flexible multibody simulation approach was proposed. The purpose of this study was to extend the idea of using the flexible multibody approach in the analysis of bone strains during physical activity through integrating the magnetic resonance imaging (MRI) technique within the framework. In order to investigate the reliability and validity of the proposed approach, a three-dimensional full body musculoskeletal model with a flexible tibia was used as a demonstration example. The model was used in a forward dynamics simulation in order to predict the tibial strains during walking on a level exercise. The flexible tibial model was developed using the actual geometry of human tibia, which was obtained from three-dimensional reconstruction of MRI. Motion capture data obtained from walking at constant velocity were used to drive the model during the inverse dynamics simulation in order to teach the muscles to reproduce the motion in the forward dynamics simulation. Based on the agreement between the literature-based in vivo strain measurements and the simulated strain results, it can be concluded that the flexible multibody approach enables reasonable predictions of bone strain in response to dynamic loading. The information obtained from the present approach can be useful in clinical applications including devising exercises to prevent bone fragility or to accelerate fracture healing.     

A comparison of mechanical properties derived from multiple skeletal sites in mice

Laboratory mice provide a versatile experimental model for studies of skeletal biomechanics. In order to determine the strength of the mouse skeleton, mechanical testing has been performed on a variety of bones using several procedures. Because of differences in testing methods, the data from previous studies are not comparable. The purpose of this study was to determine which long bone provides the values closest to the published material properties of bone, while also providing reliable and reproducible results. To do this, the femur, humerus, third metatarsal, radius, and tibia of both the low bone mass C57BL/6H (B6) and high bone mass C3H/HeJ (C3H) mice were mechanically tested under three-point bending. The biomechanical tests showed significant differences between the bones and between mouse strains for the five bones tested (p < 0.05). Computational models of the femur, metatarsal, and radius were developed to visualize the types of measurement error inherent in the three-point bending tests. The models demonstrated that measurement error arose from local deformation at the loading point, shear deformation and ring-type deformation of the cylindrical cross-section. Increasing the aspect ratio (bone length/width) improved the measurement of Young's modulus of the bone for both mouse strains (p < 0.01). Bones with the highest aspect ratio and largest cortical thickness to radius ratio were better for bending tests since less measurement error was observed in the computational models. Of the bones tested, the radius was preferred for mechanical testing because of its high aspect ratio, minimal measurement error, and low variability.     

Static and dynamic error of a biplanar videoradiography system using marker-based and markerless tracking techniques

The use of biplanar videoradiography technology has become increasingly popular for evaluating joint function in vivo. Two fundamentally different methods are currently employed to reconstruct 3D bone motions captured using this technology. Marker-based tracking requires at least three radio-opaque markers to be implanted in the bone of interest. Markerless tracking makes use of algorithms designed to match 3D bone shapes to biplanar videoradiography data. In order to reliably quantify in vivo bone motion, the systematic error of these tracking techniques should be evaluated. Herein, we present new markerless tracking software that makes use of modern GPU technology, describe a versatile method for quantifying the systematic error of a biplanar videoradiography motion capture system using independent gold standard instrumentation, and evaluate the systematic error of the W.M. Keck XROMM Facility's biplanar videoradiography system using both marker-based and markerless tracking algorithms under static and dynamic motion conditions. A polycarbonate flag embedded with 12 radio-opaque markers was used to evaluate the systematic error of the marker-based tracking algorithm. Three human cadaveric bones (distal femur, distal radius, and distal ulna) were used to evaluate the systematic error of the markerless tracking algorithm. The systematic error was evaluated by comparing motions to independent gold standard instrumentation. Static motions were compared to high accuracy linear and rotary stages while dynamic motions were compared to a high accuracy angular displacement transducer. Marker-based tracking was shown to effectively track motion to within 0.1?mm and 0.1 deg under static and dynamic conditions. Furthermore, the presented results indicate that markerless tracking can be used to effectively track rapid bone motions to within 0.15 deg for the distal aspects of the femur, radius, and ulna. Both marker-based and markerless tracking techniques were in excellent agreement with the gold standard instrumentation for both static and dynamic testing protocols. Future research will employ these techniques to quantify in vivo joint motion for high-speed upper and lower extremity impacts such as jumping, landing, and hammering.     

Bone mineral density and microarchitecture in participants of a 105-day experiment in isolated environment

A study on the bone system state in healthy volunteers has been performed before and after 105-day experiment in hermetically isolated environment (the Mars-105 experiment) using dual energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT). The values of bone mineral density (BMD), volumetric bone mineral density (VBMD), and bone structural characteristics of distal segments in radius and tibia have been evaluated. No significant DXA changes have been revealed in segments of skeleton critically important in terms of biomechanics. Microarchitectural deterioration (a decrease in the trabecula number and increase in the bone tissue heterogeneity) has been found using the pQCT technique in the radius of the majority of subjects. A VBMD decrease has been revealed for both cortical and trabecular bones in tibia, along with an unexpected trabecular bone improvement in the form of an increase in the trabecula quantity and decrease in bone tissue heterogeneity. Comprehensive studies, including estimation of projective and volumetric bone mineral densities (the bone mineral content) and bone structural characteristics (bone quality) are required to have a clear view on the changes in the bone system under the conditions of a simulation experiment.     

Flexible multibody simulation approach in the analysis of tibial strain during walking

Strains within the bone tissue play a major role in bone (re)modeling. These small strains can be assessed using experimental strain gage measurements, which are challenging and invasive. Further, the strain measurements are, in practise, limited to certain regions of superficial bones only, such as the anterior surface of the tibia. In this study, tibial strains occurring during walking were estimated using a numerical approach based on flexible multibody dynamics. In the introduced approach, a lower body musculoskeletal model was developed by employing motion capture data obtained from walking at a constant velocity. The motion capture data were used in inverse dynamics simulation to teach the muscles in the model to replicate the motion in forward dynamics simulation. The maximum and minimum tibial principal strains predicted by the model were 490 and -588 microstrain, respectively, which are in line with literature values from in vivo measurements. In conclusion, the non-invasive flexible multibody simulation approach may be used as a surrogate for experimental bone strain measurements and thus be of use in detailed strain estimations of bones in different applications.     

Strain shielding in distal femur after patellofemoral arthroplasty under different activity conditions

Strain shielding, a mechanical effect occurring in structures combining stiff with more flexible materials, is considered to lead to a reduction of density in bone surrounding the implant. This effect can be related to the weakness of the implant fixation, which can promote implant loosening. Several studies describe a significant decrease in postoperative bone mineral density adjacent to joint implants, which can compromise their long-term fixation. The aim of the present study was to quantify the strain shielding effect on the distal femur after patellofemoral arthroplasty. For this purpose three activities of daily living were considered: level walking, stair climbing and deep bending at different angles of knee flexion. To determine the strain shielding effect, cortical bone strains were measured experimentally with triaxial strain gauges in synthetic femurs before and after patellofemoral arthroplasty for each of the different daily activities. The results showed that the patellofemoral arthroplasty in general reduced the strains in the medial and distal regions of the femur when deep bending activity occurred, consequently, strain shielding in these regions, with strain decreases of ?72.0% and ?67.5% were measured. On the other side, higher values of strain were found in the anterior region after patellofemoral replacement for this activity with an increase of +182.0%. The occurrence of strain shielding seems to be more significant when the angle of knee flexion and applied load increases. Strain shielding and over-loading may have relevant effects on bone remodeling surrounding the patellofemoral implant, suggesting a potential effect of later bone resorption in the medial and distal femur regions in case of regular deep bending activity.     

Bone strain magnitude is correlated with bone strain rate in tetrapods: implications for models of mechanotransduction

Hypotheses suggest that structural integrity of vertebrate bones is maintained by controlling bone strain magnitude via adaptive modelling in response to mechanical stimuli. Increased tissue-level strain magnitude and rate have both been identified as potent stimuli leading to increased bone formation. Mechanotransduction models hypothesize that osteocytes sense bone deformation by detecting fluid flow-induced drag in the bone''s lacunar–canalicular porosity. This model suggests that the osteocyte''s intracellular response depends on fluid-flow rate, a product of bone strain rate and gradient, but does not provide a mechanism for detection of strain magnitude. Such a mechanism is necessary for bone modelling to adapt to loads, because strain magnitude is an important determinant of skeletal fracture. Using strain gauge data from the limb bones of amphibians, reptiles, birds and mammals, we identified strong correlations between strain rate and magnitude across clades employing diverse locomotor styles and degrees of rhythmicity. The breadth of our sample suggests that this pattern is likely to be a common feature of tetrapod bone loading. Moreover, finding that bone strain magnitude is encoded in strain rate at the tissue level is consistent with the hypothesis that it might be encoded in fluid-flow rate at the cellular level, facilitating bone adaptation via mechanotransduction.     

Computer modelling of bone’s adaptation: the role of normal strain,shear strain and fluid flow

Bone loss is a serious health problem. In vivo studies have found that mechanical stimulation may inhibit bone loss as elevated strain in bone induces osteogenesis, i.e. new bone formation. However, the exact relationship between mechanical environment and osteogenesis is less clear. Normal strain is considered as a prime stimulus of osteogenic activity; however, there are some instances in the literature where osteogenesis is observed in the vicinity of minimal normal strain, specifically near the neutral axis of bending in long bones. It suggests that osteogenesis may also be induced by other or secondary components of mechanical environment such as shear strain or canalicular fluid flow. As it is evident from the literature, shear strain and fluid flow can be potent stimuli of osteogenesis. This study presents a computational model to investigate the roles of these stimuli in bone adaptation. The model assumes that bone formation rate is roughly proportional to the normal, shear and fluid shear strain energy density above their osteogenic thresholds. In vivo osteogenesis due to cyclic cantilever bending of a murine tibia has been simulated. The model predicts results close to experimental findings when normal strain, and shear strain or fluid shear were combined. This study also gives a new perspective on the relation between osteogenic potential of micro-level fluid shear and that of macro-level bending shear. Attempts to establish such relations among the components of mechanical environment and corresponding osteogenesis may ultimately aid in the development of effective approaches to mitigating bone loss.     

Mechanics of locomotion and jumping in the forelimb of the horse (Equus): in vivo stress developed in the radius and metacarpus

Principal stresses acting in the midshafts of the radius and metacarpus of the horse were determined from in vivo strain recordings during locomotion and jumping. Ground forces and limb position were also recorded. Over a range of speed and gait the radius was subjected to considerable bending, whereas the metacarpus was loaded primarily in axial compression. As a result, peak stresses acting in the radius (maximum: –45 MN/m²) were consistently 50% greater than those acting in the metacarpus (maximum: –31 MN/m²). The increase in peak bone stress (radius: 119% and metacarpus; 114%) with increasing speed was matched by a 103% increase in the mass-specific vertical force ( A _v) exerted on the limb and a 55% decline in duty factor of the limb. The forelimb was closely aligned with the direction of ground force during the support phase (<9° when peak force acted) to minimize bending forces exerted on the distal limb bones. Hence, bending of the radius resulted mainly from axial forces acting about its longitudinal curvature. This was in contrast to the metacarpus, which is a much straighter bone.
Significantly greater stresses were recorded in each bone during jumping: –81 MN/m² in the radius and –53 MN/m² in the metacarpus. While the distribution of loading in the radius was similar to that during steady state locomotion, greater variability in the magnitude and/or distribution of metacarpal loading was observed between animals, largely due to differences in the orientation of the limb during takeoff and landing. These data demonstrate that the horse, despite its large size, maintains a safety factor of nearly 3–4 during peak performance.     

What do we currently know from in vivo bone strain measurements in humans?

Bone strains are the most important factors for osteogenic adaptive responses. During the past decades, scientists have been trying to describe the relationship between bone strain and bone osteogenic responses quantitatively. However, only a few studies have examined bone strains under physiological condition in humans, owing to technical difficulty and ethical restrictions. The present paper reviews previous work on in vivo bone strain measurements in humans, and the various methodologies adopted in these measurements are discussed. Several proposals are made for future work to improve our understanding of the human musculoskeletal system. Literature suggests that strains and strain patterns vary systematically in response to different locomotive activities, foot wear, and even different venues. The principal compressive, tension and engineering shear strain, compressive strain rate and shear strain rate in the tibia during running seem to be higher than those during walking. The high impact exercises, such as zig-zag hopping and basketball rebounding induced greater principal strains and strain rates in the tibia than normal activities. Also, evidence suggests an increase of tibia strain and strain rate after muscle fatigue, which strongly supports the opinion that muscle contractions play a role on the alteration of bone strain patterns.     

Accuracy and precision of digital volume correlation in quantifying displacements and strains in trabecular bone

Strain measurement is an essential tool in the study of trabecular bone structure-function relationships. Digital volume correlation (DVC) is a measurement technique that quantifies strains throughout the interior of a specimen, rather than simply those on the surface. DVC relies on tracking the movement of microstructural features, and as such, the accuracy and precision of this technique may depend on trabecular structure. This study quantified displacement and strain measurement errors in six types of trabecular bone that spanned a wide range of volume fraction and trabecular architecture. Accuracy and precision were compared across bone type and also across three DVC methods. Both simulated and real displacement fields were analyzed using micro-computed tomography images of specimens from the bovine distal femur, bovine proximal tibia, rabbit distal femur, rabbit proximal tibia, rabbit vertebra, and human vertebra. Differences as large as three-fold in accuracy and precision of the displacements and strains were found among DVC methods and among bone types. The displacement precision and the strain accuracy and precision were correlated with measures of trabecular structure such as structural model index. These results demonstrate that the performance of the DVC technique can depend on trabecular structure. Across all bone types, the displacement and strain errors ranged 1.86-3.39 microm and 345-794 microepsilon, respectively. For specimens from the human vertebra and bovine distal femur, the measurement errors were approximately 20 times smaller than the yield strain. In these cases, DVC is a viable technique for measuring pre- and post-yield strains throughout trabecular bone specimens and the trabecular compartment of whole bones.     

Torsion and Antero-Posterior Bending in the In Vivo Human Tibia Loading Regimes during Walking and Running

Bending, in addition to compression, is recognized to be a common loading pattern in long bones in animals. However, due to the technical difficulty of measuring bone deformation in humans, our current understanding of bone loading patterns in humans is very limited. In the present study, we hypothesized that bending and torsion are important loading regimes in the human tibia. In vivo tibia segment deformation in humans was assessed during walking and running utilizing a novel optical approach. Results suggest that the proximal tibia primarily bends to the posterior (bending angle: 0.15°–1.30°) and medial aspect (bending angle: 0.38°–0.90°) and that it twists externally (torsion angle: 0.67°–1.66°) in relation to the distal tibia during the stance phase of overground walking at a speed between 2.5 and 6.1 km/h. Peak posterior bending and peak torsion occurred during the first and second half of stance phase, respectively. The peak-to-peak antero-posterior (AP) bending angles increased linearly with vertical ground reaction force and speed. Similarly, peak-to-peak torsion angles increased with the vertical free moment in four of the five test subjects and with the speed in three of the test subjects. There was no correlation between peak-to-peak medio-lateral (ML) bending angles and ground reaction force or speed. On the treadmill, peak-to-peak AP bending angles increased with walking and running speed, but peak-to-peak torsion angles and peak-to-peak ML bending angles remained constant during walking. Peak-to-peak AP bending angle during treadmill running was speed-dependent and larger than that observed during walking. In contrast, peak-to-peak tibia torsion angle was smaller during treadmill running than during walking. To conclude, bending and torsion of substantial magnitude were observed in the human tibia during walking and running. A systematic distribution of peak amplitude was found during the first and second parts of the stance phase.