Histologic estimation of age at death using the anterior cortex of the femur

This report describes a new histologic method for determination of age at death, the latest in a series of studies that began with Kerley's pioneer presentation in 1965. The study population was collected from 328 documented individuals from an anatomy dissecting room in the United States, from two modern cemeteries in the Dominican Republic, and from autopsies performed in a Chilean hospital. Undecalcified thin sections 1.0 cm wide were made from specimens taken from the femoral midshaft directly opposite the linea aspera. Five 0.886 mm2 fields were located at the periosteal edge and photographed, mainly for purposes of defining the fields and providing a permanent record. Secondary osteons, type II osteons, osteon fragments, resorption spaces, and non-Haversian canals were recorded as number/mm2, and a 100-space grid was used to measure average percent of unremodeled, osteonal, and fragmental bone. Stepwise regression analysis of the measurements produced a series of regression equations for age estimation for females, males, and sexes combined. Most equations have a standard error of estimate of about 10 years, but the coefficients of determination (r2) range from 0.48 to 0.72. In practice, sex-specific equations gave better results than opposite-sex or nonspecific equations, mainly because males and females differed in the pattern of relations between osteons and osteon fragments with advancing age.     

Percent osteonal bone versus osteon counts: the variable of choice for estimating age at death.

Ahlqvist and Damsten's (1969) modification of the Kerley (1965) method for histological age estimation uses percent osteonal bone, rather than actual osteon counts, in order to eliminate the difficulty of distinguishing between intact and fragmentary osteons. Since their method has been developed for the femur only, and several more recent methods have been proposed that utilize percent osteonal bone, a study was undertaken to ascertain the relative value of percent osteonal bone compared with osteon counts to estimate age at death for the radius, tibia, and fibula. First the question of how much of the cross-section of a bone should be sampled was addressed by comparing the results of regression against age for percent osteonal bone derived from sampling only four fields with those derived from the entire cross-section of the radius. A significant age association was found only when the entire cross-section was sampled. In order to evaluate the relative merit of using either percent osteonal bone, or osteon counts to estimate age, each variable was regressed against age. Significant correlation coefficients were found for all three bones when the independent variable was osteon counts. When percent osteonal bone was employed, a significant correlation was found only for the radius. Stepwise linear regression found osteon counts for the fibula alone to be the best age predictor. Finally, a repeated measures analysis of variance revealed that percent osteonal bone and osteon counts both differ among the three bones within an individual. Based upon these results, osteon counts, rather than percent osteonal bone, should be the variable of choice when developing histological age predicting methods.     

Variation in cortical bone histology within the human femur and its impact on estimating age at death

Histological methods for the estimation of age at death using cortical bone are based on the evaluation of microstructural changes over time. Since histological analysis is a destructive method, most techniques attempt to limit the amount of cortical bone needed for analysis. Sample location, however, can have a significant effect on the accuracy of these methods. Furthermore, research demonstrates that both intersection and intrasection variation is present at the midshaft of the femur, which is the primary location for estimating age at death in humans. This research determines the extent of regional variation within the adult human femur and its effect on age estimation. Secondary osteon lamellae and Haversian canal ratio and cortical thickness were quantified. Thompson's All Males Left Femur regression equation was used to estimate age. Results show that significant regional variation occurs in the estimated ages derived from the posterior aspect of the femoral shaft and significant intrasection variation occurs in age estimates from the mid and mid-distal cross-sections. Thus, the inter and intrasection variation that occurs in bone remodeling within the femoral cortex has the potential to produce significant differences amongst age estimates taken from various femoral diaphyseal locations compared to the age estimated from the standard location used in Thompson's core method (1978). The results indicate that the use of this histological method is dependant on the ability to correctly identify the four anatomical locations, but the extracted core used for age estimation is not necessarily confined to the anterior midshaft.     

Brief communication: The effects of disuse on the mechanical properties of bone: What unloading tells us about the adaptive nature of skeletal tissue

The intricate link between load environment and skeletal health is exemplified by the severe osteopenia that accompanies prolonged periods of immobilization, frequently referred to as disuse osteoporosis. Investigating the effects disuse has on the structural properties of bone provides a unique opportunity to better understand how mechanical loads influence the adaptation and maintenance of skeletal tissue. Here, we report results from an examination of multiple indicators of bone metabolism (e.g., mean osteon density, mean osteon size, bone mass, and bone area distribution) within the major long bones of individuals with distinct activity level differences. Results are based on a sample comprising two subjects that suffered from long‐term quadriplegia and 28 individuals of comparable age that had full limb mobility. Although limited in sample size, our findings suggest bones associated with long‐term disuse have lower osteon densities and larger osteon areas compared to individuals of normal mobility, reflecting dramatically lower remodeling rates potentially related to reduced strain levels. Moreover, immobilized skeletal elements demonstrate a reduced percentage of cortical area present resulting from endosteal resorption. Differences between mobility groups in the percentage of cortical area present and bone distribution of all skeletal elements, suggests bone modeling activity is negligible in the unloaded adult skeleton. Additional histomorphometric comparisons reveal potential intraskeletal differences in bone turnover rates suggesting remodeling rates are highest within the humeri and femora. Addition of more immobilized individuals in the future will allow for quantitative statistical analyses and greater consideration of human variation within and between individuals. Am J Phys Anthropol 2012. © 2012 Wiley Periodicals, Inc.     

Age estimation from cortical index of the human clavicle in northwest Indians

The proportion of the cortical thickness to the total diameter of the bone (cortical index) was calculated in paired clavicles obtained from 128 male and 82 female medicolegal postmortem subjects who were apparently healthy prior to their accidental death. The ages of the subjects varied from 15 to 85 years. The clavicles were cut either horizontally or parasagittally, and measurements were taken at midclavicle. From the ages of 15 to 30 years, the cortical index increased. It decreased steadily thereafter, with an initial sharp decrease in the age group 31-40 years in both sexes. After the age of 40 years, this rapid decrease in the index continued in the females, but became slow and gradual in the males. Differences between left and right sides were statistically insignificant in both sexes (P greater than 0.05). However, the sexual differences were significant (P less than 0.01) in the age groups from 41 years onwards.     

Patterns of femoral bone remodeling dynamics in a medieval Nubian population

The relationship between age, sex and histomorphometry in femoral cortical bone was examined in a skeletal population of late Medieval antiquity (AD 1250–1450) from Kulubnarti, in Sudanese Nubia. These skeletal remains are naturally mummified and in an excellent state of preservation. The study sample consisted of femoral cross sections from 24 females and 19 males ranging in age from 20 to 50+ years. Femoral cross sections were examined using an image analysis system. Numbers of secondary osteons and osteon fragments were counted, osteon area and Haversian canal area were measured, and several variables were calculated to assess differences between sexes and among age groups in bone remodeling variables. The results indicate significant differences between the sexes in osteon number and size. Males had significantly more intact osteons than females, whereas females had significantly larger osteons than males. Haversian canal dimensions were not statistically significant between the sexes. Sex differences in activity patterns in which males were involved in more physically strenuous tasks may have contributed to differences in remodeling variables. Interpopulational comparisons suggest that mechanical strain affects the microstructural features examined in this study. In particular, small Haversian canals in some archaeological skeletal populations are associated with higher bone volume, which may result from high levels of mechanical strain. Am J Phys Anthropol 104:133–146, 1997. © 1997 Wiley-Liss, Inc.     

Effect of age on bone mineral density and micro architecture in the radius and tibia of horses: An Xtreme computed tomographic study

Background

The effect of age on the bone mineral density and microarchitecture of the equine radius and tibia was investigated. Fifty-six bones from 15 horses aged four to 21 years were used. There were nine geldings and six mares, and none of the horses had any disease influencing bone properties. Xtreme computed tomography was used to evaluate a 9-mm segment of the diaphysis and metaphysis of each bone. The following variables were determined: length of the bone, circumference and diameter in the frontal and sagittal planes in the middle of the bone.Diaphysis: total volume, bone volume, bone volume ratio, slice area, bone area, marrow area, cortical and marrow thickness, bone mineral density, polar moment of inertia of the cortex.Metaphysis: total area, bone area, cortical bone area, cortical thickness, bone mineral density, bone mineral density in the cortex, bone mineral density in the trabecular region, trabecular number, trabecular thickness, trabecular separation, polar moment of inertia of the metaphysis, polar moment of inertia of the cortex of the metaphysis.

Results

Bone density and microarchitecture were not affected by breed or gender. However, the microarchitecture varied with the age of the horse; the number of trabeculae decreased significantly and the distance between trabeculae increased significantly with increasing age. There were no significant differences between bones of the left and right limbs or between the radius and tibia.

Conclusion

The variables investigated did not differ between geldings and mares. However, there were age-related changes in the microstructure of the bones. Further experimental studies are necessary to determine whether these changes reduce bone strength. Age-related changes in the bones were seen and may explain the higher incidence of fractures and fissures in older horses.

     

Regional variations in cortical modeling in the femoral mid-shaft: sex and age differences

Modern lifestyle changes may result in site-specific alterations in the skeleton. Our aim was to determine sex and age differences in regional geometry at the mid-femur. Complete cross sections from 113 individuals aged 20-97 years from a modern Australian population were obtained. A further subsample of 24, in whom the precise orientation of specimens was known, was subsequently collected. Microradiographs were made of 100-microm sections and the bone was analyzed using image processing software (Optimas, Media Cybernetics). The periosteal boundary was extracted automatically and the centroid of the periosteal outline was calculated. Fourier shape analysis was used to delineate the endocortical surface. Radial and cortical widths in each quadrant were determined. The posterior was identified by the linea aspera, and the medial and lateral were indistinguishable and therefore grouped together. For analysis, the entire sample was divided into three groups: young (20-40 years), middle (41-60 years), and old (61+ years). Raw and height-normalized values were analyzed with SPSS using t-tests, analysis of variance, and Tukey's honestly significant difference (HSD) tests. The results show that with age the femoral mid-shaft in both sexes becomes larger and more circular, with a slight shift towards the anterior. Apposition is least on the posterior and resorption greatest on the anterior, the latter being particularly evident in postmenopausal females. The greatest sex differences are seen in the middle years, lessening again in the old. We conclude that differential circumferential modeling in response to functional and postural changes occurs in both sexes with age.     

Collagen orientation patterns in human secondary osteons, quantified in the radial direction by confocal microscopy

The composite structure of secondary osteon lamellae, key micro-mechanical components of human bone, has intrigued researchers for the last 300 years. Scanning confocal microscopy here for the first time systematically quantifies collagen orientations by location within the lamellar thickness. Fully calcified lamellar specimens, extinct or bright in cross-section under circularly polarized light, were gently flattened, and then examined along their thickness direction, the radial direction in the previously embedding osteon. Collagen orientation was measured from confocal image stacks. So-called extinct lamellae and so-called bright lamellae are found to display distinct, characteristic patterns of collagen orientation distribution. Orientations longitudinal to the osteon axis in extinct lamellae, transverse to the osteon axis in bright lamellae, and oblique to the osteon axis in both lamellar types, show parabolic distribution through specimen thickness. Longitudinal collagen in extinct lamellae, and transverse collagen in bright lamellae, peaks at middle third of lamellar thickness, while oblique collagen peaks at outer thirds of both types. Throughout the thickness, longitudinal collagen orientations characterize extinct lamellar specimens, while orientations oblique to the original osteon axis characterize bright lamellar specimens. Measured patterns complement previous indirect results by different methods and reinforce previously hypothesized differences in lamellar mechanical functions.     

The effects of socioeconomic status on endochondral and appositional bone growth,and acquisition of cortical bone in children from 19th century Birmingham,England

Endochondral growth, appositional growth, and acquisition of cortical bone thickness in the femur are investigated in subadult skeletons (N = 43, dental age range birth to 12 years) from the 19^th‐century AD burial site of St. Martin's churchyard, Birmingham, England. Endochondral growth is monitored using diaphyseal femoral length. Appositional growth is monitored using radiographic midshaft mediolateral width and acquisition of cortical bone using combined mediolateral cortical thickness measured at the midshaft from radiographs. The methodology involves plotting these variables against dental age. Growth is compared in children of differing socioeconomic status. Higher and lower status individuals are identified in the assemblage by their burial in brick vaults in the case of the former and in earth‐cut graves in the case of the latter. The relationships between bone dimensions and dental age are described using a polynomial regression procedure, and analysis of regression residuals is used to evaluate differences in bone dimension‐for‐dental age between the two status groups. Results show that lower socioeconomic status individuals had lower cortical thickness‐for‐dental age than those of higher status. This was interpreted as likely reflecting poorer nutrition in the children of lower socioeconomic backgrounds. There was no patterning with respect to socioeconomic status in femur diaphyseal length or midshaft width. The results support the idea that, for skeletal populations, growth in cortical thickness may be a more sensitive indicator of adverse conditions in childhood than growth in bone length or width. Am J Phys Anthropol, 2009. © 2009 Wiley‐Liss, Inc.     

Measuring and interpreting age‐related loss of vertebral bone mineral density in a medieval population

This study investigates the age‐ and sex‐related patterns in vertebral bone mineral density (BMD) and the relationship between BMD and vertebral osteophytosis (VO), using a specialized peripheral densitometer in a skeletal sample excavated from the British medieval village Wharram Percy. A total of 58 individuals were divided by sex into three broad age categories (18–29, 30–49, 50+ years.). Each fourth intact vertebral centra was scored for VO and 5‐mm thick coronal sections scanned in a specialized peripheral densitometer (GE Lunar Piximus DXA). Changes in BMD associated with age, sex, and VO severity were examined in the whole vertebral section, a strictly trabecular region, and a primarily cortical region of bone separately. Significant change in vertebral BMD was found to occur by middle age with little or no statistical change in BMD between middle and old age. Females appear to suffer greater bone loss at an earlier age with no change in BMD between middle and old age, whereas males show a more steady loss of BMD across the age groups. The bone mineral content and BMD of the cortical region is higher in individuals with pronounced/severe osteophytosis. The unusual age‐ and sex‐related patterns of change in vertebral BMD at Wharram Percy are compared with the patterns of age‐related change from recent longitudinal population‐based studies. The results emphasize the different pattern of bone loss in young adulthood seen in trabecular regions of the skeleton and highlight the importance of consideration of degenerative joint disease in BMD studies. The influence of lifestyle factors on vertebral BMD in this medieval population is also discussed. Am J Phys Anthropol 2009. © 2009 Wiley‐Liss, Inc.     

Characteristics and Stimulation Potential with BMP-2 and BMP-7 of Tenocyte-Like Cells Isolated from the Rotator Cuff of Female Donors

Tendon bone healing of the rotator cuff is often associated with non-healing or recurrent defects, which seems to be influenced by the patient’s age and sex. The present study aims to examine cellular biological characteristics of tenocyte-like cells that may contribute to this impaired rotator cuff healing. Moreover, a therapeutic approach using growth factors could possibly stimulate tendon bone healing. Therefore, our second aim was to identify patient groups who would particularly benefit from growth factor stimulation. Tenocyte-like cells isolated from supraspinatus tendons of female donors younger and older than 65 years of age were characterized with respect to different cellular biological parameters, such as cell density, cell count, marker expression, collagen-I protein synthesis, and stem cell potential. Furthermore, cells of the donor groups were stimulated with BMP-2 and BMP-7 (200 and 1000 ng/ml) in 3D-culture and analyzed for cell count, marker expression and collagen-I protein synthesis. Female donors older than 65 years of age showed significantly decreased cell count and collagen-I protein synthesis compared to cells from donors younger than 65 years. Cellular biological parameters including cell count, collagen-I and –III expression, and collagen-I protein synthesis of cells from both donor groups were stimulated with BMP-2 and BMP-7. The cells from donors older than 65 years revealed a decreased stimulation potential for cell count compared to the younger group. Cells from female donors older than 65 years of age showed inferior cellular biological characteristics. This may be one reason for a weaker healing potential observed in older female patients and should be taken into consideration for tendon bone healing of the rotator cuff.     

Influence of age and gender on radiomorphometric indices of the mandible in removable denture wearers

The objective of this study was to measure and assess a number of radiomorphometric indices of the mandibular removable denture wearers taking into account age and gender. In a total of 136 dental panoramic radiographs (DPR) the following parameters were evaluated: MI = thickness of the mandibular cortex below the mental foramen, AI = thickness at the antegonion and GI = thickness at gonion; PMI = MI/distance between the low border of the mandible and the low border of the mental foramen, and MCI = mandibular cortical index, based on the assessment of the 3 categories of cortical appearance due to the resorptive changes. There were 40 male patients (mean age 72.7; range 56 to 84 years) and 96 female patients (mean age 69.7; range 48 to 86 years). Patients were grouped according to age into three age groups (1 = less than 65 years; 2 = 65-75 years; 3 = more than 75 years). The results revealed that MI, PMI, AI and GI showed a general downward trend with age for the both sexes until 75 years of age when the mean values of GI, AI and MI begun to fall down sharply for females compared to males. The difference was significant between age groups and gender for GI and AI. Only two categories (C2 and C3) of MCI have been recognized in our study sample, due to the relatively old age groups of patients with removable dentures. However, significantly higher incidence of C3 existed in the oldest group of females.     

Residual stress distribution in rabbit limb bones

The presence of the residual stresses in bone tissue has been noted and the authors have reported that there are residual stresses in bone tissue. The aim of our study is to measure the residual stress distribution in the cortical bone of the extremities of vertebrates and to describe the relationships with the osteon population density. The study used the rabbit limb bones (femur, tibia/fibula, humerus, and radius/ulna) and measured the residual stresses in the bone axial direction at anterior and posterior positions on the cortical surface. The osteons at the sections at the measurement positions were observed by microscopy. As a result, the average stresses at the hindlimb bones and the forelimb bones were 210 and 149 MPa, respectively. In the femur, humerus, and radius/ulna, the residual stresses at the anterior position were larger than those at the posterior position, while in the tibia, the stress at the posterior position was larger than that at the anterior position. Further, in the femur and humerus, the osteon population densities in the anterior positions were larger than those in the posterior positions. In the tibia, the osteon population density in the posterior position was larger than that in the anterior position. Therefore, tensile residual stresses were observed at every measurement position in the rabbit limb bones and the value of residual stress correlated with the osteon population density (r=0.55, P<0.01).     

Brief communication: histological age estimation using rib and clavicle.

Histological methods for estimating age at death using osteon population densities for the rib, clavicle, and rib and clavicle combined are presented. Predicting formulas were generated from a sample of 40 individuals of known age, sex, and race. Independent samples of 12 ribs and 7 clavicles were used to test the formulas. Mean differences between known and predicted ages were 1.1 years, 2.6 years, and 3.4 years for the clavicle, rib and clavicle combined, and rib formulas respectively. An analysis of variance found no significant differences among the means for predicted and known ages. Since the formula based upon rib and clavicle combined has the higher standard error and r2, and includes data from different bones, it should provide better overall accuracy and reliability, and is recommended whenever both bones are available.     

Trabecular bone modeling and subcapital femoral fracture

Fragility fractures, including neck of femur fractures, result from reductions in the amount, quality and architecture of bone. The aim of this study was to compare the cancellous bone structure, and static indices of bone turnover, in female patients who had sustained fragility fracture at the femoral neck, with age-matched females without fragility fracture. Bone samples were taken from the intertrochanteric region of the proximal femur of female patients undergoing hip arthroplasty surgery for a subcapital fragility fracture of the femoral neck (#NOF) or from age-matched female control individuals at routine autopsy. The histomorphometric data, which were normally distributed, indicated no difference between the mean values for any of the structural parameters in control and fracture samples. In particular, the BV/TV values were not different and did not change significantly with age in these cohorts of individuals aged >65 years. The static indices of bone turnover, eroded surface (ES/BS) and osteoid surface (OS/BS), were positively correlated with age in the >65-year-old control group (p<0.05 and p<0.03, respectively). The median values for these indices were not different between the fracture and control groups. However, both the median and the range of OS/BS values were increased for >65-year-old controls compared with a group of younger females aged <65 years, suggesting an increase in bone formation in older females in the proximal femur after 65 years of age. When the data were further interrogated, a reduction in the percentage osteoid surface to eroded surface quotient (OS/ES) was found for the fracture group compared with the age-matched control group. These data indicate that perturbations in bone formation and/or resorption surface are potentially important in producing bone in the proximal femur with increased propensity to fracture. These data also support the concept that trabecular bone modeling may be a factor influencing bone strength in addition to bone mass.     

Technical note: A stereological analysis of the cross‐sectional variability of the femoral osteon population

Unbiased selection of regions of interest (ROIs) and unbiased definition of histological structures are needed to improve the repeatability of microscopic methods for age at death determination and to reduce operator subjectivity. We present results obtained by selecting ROIs according to stereological principles on a sample of 28 femoral cross sections of Caucasoid males aged 20–89 years. A regular grid was overlaid on the cross section, and the ROIs were selected as close as possible to the periosteum in the anterior, lateral, and medial regions. The areas consisting of all intact secondary osteons plus fragments were outlined and osteon population density, percent osteon population, area, and perimeter were calculated using stereological methods and software. Overall, the analyses of intra‐ and inter‐section variability showed no significant difference between the ROIs, i.e., the location within the cross section of the ROIs does not affect the outcome of the analyses. The individual variability was found to be higher in adults aged 30–55 years than in other age ranges. ranges. Am J Phys Anthropol 2010. © 2010 Wiley‐Liss, Inc.     

Preservation of femoral bone thickness in middle age predicts survival in genetically heterogeneous mice

To see whether age-related changes in bone could predict subsequent lifespan, we measured multiple aspects of femur size and shape at 4, 15, and 24 months of age in genetically heterogeneous mice. Mice whose cortical bone became thicker from 4 to 15 months, associated with preservation of the endosteal perimeter, survived longer than mice whose endosteal cavity expanded, at the expense of cortical bone, over this age range. Femur size at age 4 months was also associated with a difference in life expectancy: mice with larger bones (measured by length, cortical thickness, or periosteal perimeter) had shorter lifespans. Femur length, midlife change in cortical bone thickness, and midlife values of CD8 T memory cells each added significant power for longevity prediction. Mice in the upper half of the population for each of these three endpoints lived, on average, 103 days (12%) longer than mice with the opposite characteristics. Thus, measures of young adult bone dimensions, changes as a result of bone remodeling in middle age, and immunological maturation provide partially independent indices of aging processes that together help to determine lifespan in genetically heterogeneous mice.     

Effects of the basic multicellular unit and lamellar thickness on osteonal fatigue life

A remodeling cycle sets the size of the osteon and associated lamellae in the basic multicellular unit. Treatments and aging affect these micro-structural features. We previously demonstrated decreased fatigue life with an unexplained mechanism and decreased osteon size in cortical bone treated with high-dose bisphosphonate. Here, three finite element models were examined: type-1: a single osteon, as a homogeneous unit and with heterogeneous lamellae and interlamellae, type-2: a control, interstitial-only tissue and type-3: the osteon with cement line, set within the interstitial tissue. Models were loaded in simulated, sinusoidal bending fatigue. As osteon size was decreased, lamellar number and lamellar thickness were incrementally adjusted for each model. As hypothesized, lamellae within the larger type-1 models attained greater cycles to failure and the addition of an osteon to type-2 models (generating a type-3 model set) yielded increased fatigue life. However, as the osteon size was decreased, the potential for compressive damage nucleation was increased within the lamellae of the osteons versus the interstitium. Also, osteons with fewer, thicker lamellae displayed increased fatigue life. Osteonal microstructure plays a role in damage initiation location, especially when BMU size is smaller. Previous findings by us and others could partially be explained by this further understanding of increased probability for damage nucleation in smaller osteons.