pQCT provides better prediction of canine femur breaking load than does DXA

Our study was designed to examine the validity of dual energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) measurements as predictors of whole bone breaking strength in beagle femora. DXA was used to determine the bone mineral content, bone area, and 'areal' bone mineral density. PQCT was used to determine the cross-sectional moments of inertia, volumetric densities of the bone, and to calculate bone strength indices based on bone geometry and density. A three-point bending mechanical test was used to determine maximal load. Three variables from the pQCT data set explained 88% of the variance in maximal load, with the volumetric bone mineral density explaining 32% of the variance. The addition of the volumetric cortical density increased the adjusted r(2) to 0.601 (p=0.001) and the addition of an index created by multiplying volumetric cortical bone density by the maximum cross-sectional moment of inertia made further significant (p<0.001) improvements to an adjusted r(2) of 0.877. In comparison, when only the DXA variables were considered in a multiple regression model, areal bone mineral density was the only variable entered and explained only 51% (p<0.001) of the variance in maximal load. These results suggest that pQCT can better predict maximal load in whole beagle femora since pQCT provides information on the bone's architecture in addition to its volumetric density.     

The contribution of cancellous bone to long bone strength and rigidity

A recent article (Burr and Piotrowski, 1982) suggested that structural analyses of long bone cross-sectional geometry will be inaccurate and should be considered inappropriate when cancellous bone accounts for 10-15% or more of the cross-sectional area. Consideration of material property differences between compact and cancellous bone, however, indicates that even significant proportions of cancellous bone (10-40% of total cross-sectional area) will very likely have negligible effects on bone strength and rigidity, and can be effectively ignored in geometrical analyses of diaphyseal sections. In metaphyseal and epiphyseal regions, however, geometric analyses of section properties such as area moments of inertia are inappropriate, both because of significant trabecular bone effects, and because of the inherent constraints of mechanical beam models.     

The effect of swimming activity on bone architecture in growing rats

The effect of non-habitual physical activity on bone architecture in the rat humeral shaft was examined. Two groups of rats were trained to swim for 1 h a day, for 20 weeks, at two training levels. The control group consisted of sedentary rats. Parameters of cross-sectional bone morphology (cross-section areas, principal area moments of inertia and their ratio) were used to evaluate the response of bone architecture to mechanical loading. The strength of bone was assessed by measuring the ultimate compressive force and stress. The cortical cross-section area and principal moments of inertia were found to be significantly higher in the swimming groups than in the controls. Examination of the ratio between the major and minor moments of inertia revealed a pronounced change in the shape of the bone cross-section which became more rounded following swimming training. The ultimate compressive force was significantly higher in the swimming rats while the changes in ultimate stress were not significant. Our results indicate a gain of bone strength due to increased periosteal apposition and modified bone tissue distribution. The marked changes in bone morphology are attributed to the different nature of the forces and moments exerted on the humerus during swimming compared to those prevailing during normal locomotion.     

Humeral cross-sectional morphology from 18th century Quebec prisoners of war: Limits to activity reconstruction

This study uses measures of cross-sectional robusticity and asymmetry (based on humeral areal and inertial cross-sectional components) to test a prediction from bone remodeling theory that a physically active 18th century Quebec prisoner of war sample (N = 25) should have more robust and asymmetrical humeri than a nonphysically active 20th century New Mexico suburbanite sample (N = 27). Narrative accounts document that prisoners of war engaged in labor-intensive activities, and these activities were confirmed by observations of osteoarthritis and other pathologies. The suburbanite sample, for the most part, did not engage in such activities. The prisoners had higher levels of pathology than the suburbanites (e.g., 80% vs. 22% osteoarthritis; F = 17.95, P < 0.01). For robusticity, the populations did not differ significantly in total area, cortical area, moment areas of inertia about the mediolateral plane, or polar moment area of inertia. The Quebec prison sample did have significantly higher values for moment areas of inertia about the anteroposterior plane. For asymmetry, the populations did not differ in any values (total area, cortical area, moment areas of inertia about the mediolateral plane, moment areas of inertia about the anteroposterior plane, or polar moment of inertia). Thus, examinations of cross-sectional robusticity and asymmetry failed to conclusively confirm the hypothesis that intensive labor leads to changes in humeral morphology. Possible explanations for the lack of differences are discussed, such as poor diet impeding bone remodeling. Nevertheless, the one significant finding suggests that cross-sectional shape is more useful in reconstructing activity patterns than amount of bone in a cross section. Results from this study join those from other recent investigations to suggest that additional controls are required before cross-sectional differences may be confidently attributed to activity patterns.     

Cross-sectional geometric properties of the Otavipithecus mandible

Cross-sectional geometric properties of the postcanine mandibular corpus are determined for the only known specimen of Otavipithecus namibiensis, a middle Miocene hominoid from southern Africa. It is shown that Otavipithecus is unique in that several important mechanical properties of its mandible, including maximum and minimum moments of inertia and distribution of cortical bone, differ from patterns seen in both extant hominoids and the early hominids Australopithecus africanus and Australopithecus (Paranthropus) robustus. This is particularly apparent in the mechanical design of the posterior portion of the mandibular corpus for resisting increased torsional and transverse bending moments. Cortical index values at the level of M₂ also reveal that both Otavipithecus and A. africanus are similarly designed to resist increased masticatory loads with relatively less cortical bone area, a highly efficient mechanical design. © 1996 Wiley-Liss, Inc.     

Adaptations to free-fall impact are different in the shafts and bone ends of rat forelimbs.

Impact exercise can have beneficial effects on the growing skeleton. To understand what changes it promotes in the shafts and ends of weight-bearing bones, we measured the effects of impact from repetitive free falls in growing rats. Fischer 344 female rats, 6.5 wk old, were assigned to one of three groups (n = 10 each). Controls were not dropped, whereas those subjected to impact were dropped from 30 or 60 cm. Rats in both free-fall groups were dropped 10 times per day for 8 wk. Leg bones were mechanically tested, and their cross-sectional area (CSA), cross-sectional moments of inertia, and volumetric bone mineral density (BMD) were measured by peripheral quantitative computed tomography. In the shafts of the forelimbs, but not the hindlimbs, free-fall impact resulted in greater ultimate breaking force, minimum and maximum second moments of area, and CSA but not BMD. In the bone ends of the forelimb and tibial bones, trabecular BMD increased but CSA did not. Landing from 30 and 60 cm produced peak impact forces of 12.0 and 16.7 times the standing forefoot weight for each front leg and of 4.5 and 7.7 times the standing hind foot weight for each hind foot. Overall, free-fall impact affected the forelimbs by increasing trabecular bone density in the bone ends and improving the strength at the shaft as a result of geometric improvements. These results indicate that adaptation to impact may occur by different mechanisms in bone end and shaft regions.     

Allometry between length and cross-sectional dimensions of the femur and tibia in Homo sapiens sapiens

Allometric equations relating length and cross-sectional geometric properties of the femur and tibia are generated using skeletal remains from three recent human population samples. Approximate isometry, or geometric similarity, is found both within and between samples. Cross-sectional areas scale to approximately length2, while second moments of area scale to approximately length4. It is shown that this is consistent with the maintenance of equivalent mechanical stress in long bones of different length under dynamic loadings in vivo. Other evidence indicates that bending and torsional loadings are more critical than axial loadings in the determination of lower limb bone cross-sectional dimensions.     

The effects of changing bone and muscle size on limb inertial properties and limb dynamics: a computer simulation

The magnitude and distribution of bone and muscle mass within limbs affect limb inertial properties, maximum movement speed and the energy required to maintain submaximal movements. Musculoskeletal modeling and movement simulations were used to determine how changes in bone and muscle cross-sectional area (and thus mass) affect human thigh and shank inertial properties, the maximum speed of unloaded single-leg cycling and the energy required to sustain submaximal single-leg cycling. Depending on initial conditions, shank moments of inertia increased 61-72 kg cm2 per kg added bone and 72-100 kg cm2 per kg added muscle. Thigh moments of inertia increased 46-63 kg cm2 per kg bone and 180-225 kg cm2 per kg muscle. Maximum unloaded cycling velocity increased with increased muscle mass (approximately 2.2-2.9 rpm/kg muscle), but decreased with increased cortical bone mass (approximately 2.0-2.8 rpm/kg bone). The internal work associated with unloaded submaximal cycling increased with increased muscle mass (approximately 0.42-0.48 J/kg muscle) and bone mass (approximately 0.18-0.22 J/kg bone).     

Critical ages and stages of puberty in the accumulation of spinal and femoral bone mass: the validity of bone mass measurements

In growing children, lumbar and femoral areal bone mineral density (aBMD), as measured by dual-energy X-ray absorptiometry (DXA), is influenced by skeletal growth and bone size. Correction of lumbar bone mineral density (BMD) for bone volume (volumetric BMD [vBMD]), by the use of mathematical extrapolations, reduces the confounding effect of bone size, but vBMD remains dependent on age and bone size during growth. Femoral (neck and mid-shaft) vBMD, assessed by DXA, is independent of age prior to puberty, but a slight increase occurs in late puberty and after menarche. Femoral (mid-shaft) cortical bone density and radial cortical and trabecular bone densities, assessed by quantitative computed tomography (QCT), show no peak during childhood or adolescence. Bone strength index, calculated by peripheral QCT, increases with age and correlates with handgrip strength, bone cross-sectional area and cortical area. Puberty is one of the main factors that influences lumbar bone mineral content and aBMD accumulation, but a high incidence of fractures occurs during this period of life, which may be associated with a reduced aBMD.     

Continuing periosteal apposition. II: The significance of peak bone mass, strain equilibrium, and age-related activity differentials for mechanical compensation in human tubular bones

It is generally presumed that compensation for the reduction of bone strength by progressive endosteal bone loss in adults is provided by continuing periosteal apposition (CPA) of new lamellar bone. However, the appropriate magnitude of compensatory bone growth, and the parameters that operate to determine that magnitude, are unknown. This paper examines the mechanical compensation hypothesis in a series of right-circular tubular bone analogues. Under this hypothesis, the stated objective of CPA is maintenance of the cross-sectional geometric properties of the element. These include the second and polar moments of area, as well as the cortical area of the section (I, J, and CA, respectively). This study assumes that, as resorption and apposition proceed, geometric change is isometric (shape preserving). The analysis suggests that for a given rate of endosteal bone loss (the stimulus), the magnitude of periosteal growth (the response) required to maintain geometric strength is determined by the maximum ratio (CT0) of the radial distances from the section centroid to the endosteal and periosteal surfaces (i.e., cortical thickness prior to the onset of progressive endosteal bone loss, or peak bone mass). The analysis also indicates that, for any given individual, the amount of compensatory periosteal gain required may be very small. This is particularly true for individuals having a large CT0 and for whom the magnitude of dynamic loading imparted to the skeleton declines with advancing age. This finding is illustrated in a model that relates concepts of bone surface remodeling equilibria and age-related activity differentials.     

An investigation of the interactions between lower-limb bone morphology,limb inertial properties and limb dynamics

Bone mass and size clearly affect the safety and survival of wild animals as well as human beings, however, little is known about the interactions between bone size and movement dynamics. A modeling approach was used to investigate the hypothesis that increased bone cortical area causes increased limb moments of inertia, decreased lower-limb movement maximum velocities, and increased energy requirements to sustain submaximum lower-limb locomotion movements. Custom software and digital data of a human leg were used to simulate femur, tibia, and fibula cortical bone area increases of 0%, 22%, 50%, and 80%. Limb segment masses, center of mass locations, and moments of inertia in the sagittal plane were calculated for each bone condition. Movement simulations of unloaded running and cycling motions were performed. Linear regression analyses were used to determine the magnitude of the effect cortical area has on limb moment of inertia, velocity, and the internal work required to move the limbs at a given velocity. The thigh and shank moment of inertia increased linearly up to 1.5% and 6.9%, respectively for an 80% increase in cortical area resulting in 1.3% and 2.0% decreases in maximum unloaded cycling and running velocities, respectively, and in 3.0% and 2.9% increases in internal work for the cycling and running motions, respectively. These results support the hypothesis and though small changes in movement speed and energy demands were observed, such changes may have played an important role in animal survival as bones evolved and became less robust.     

Cortical bone growth and dietary stress among subadults from Nubia's Batn el Hajar

Cortical bone growth is analyzed for 174 children from a Medieval Christian population at Kulubnarti in the Batn el Hajar of Sudanese Nubia (550–1450 AD ). Using the tibia as a representative long bone, total subperiosteal area, cortical area, medullary area, and percent cortical area at midshaft were calculated. While growth in total and cortical areas, as well as in length, appear to be fairly well maintained, percent cortical area reveals unusual growth patterns which reflect excessive endosteal resorption. Compared to the relative reduction in bone mass which has been observed in malnourished living children, as well as with previously reported evidence for stress in the Kulubnarti population, the present data support an interpretation of nutritionally related stress and of no major diachronic dietary change.     

Effects of physical training on cortical bone at midtibia assessed by peripheral QCT.

Effects of long-term exercise on volumetric bone mineral density (vBMD), bone mineral content, bone geometric properties, and the strength indexes of bone were examined in a cross-sectional study of athletes and controls. Tibias of 25 jumpers (13 women), 30 swimmers (15 women), and 25 controls (15 women), aged 18-23 yr, were scanned at midsite by using peripheral quantitative computed tomography. The cortical vBMD of female athletes was lower than that of the controls (2.00 +/- 0.05, 1.90 +/- 0.08, and 1.92 +/- 0.12 g/cm3, respectively, for controls, swimmers, and jumpers). On the other hand, periosteal areas of male jumpers and female athletes were greater than that of controls (460 +/- 50, 483 +/- 46, and 512 +/- 55 mm2, respectively, for male controls, swimmers, and jumpers, and 283 +/- 52, 341 +/- 73, and 378 +/- 75 mm2, respectively, for female controls, swimmers, and jumpers). The endocortical area of female swimmers was greater than that of controls (103 +/- 29, 148 +/- 52, and 135 +/- 54 mm2, respectively, for controls, swimmers, and jumpers). The polar moment of inertia and strength strain index of male jumpers and female athletes were significantly greater than those of controls, except for the difference in strength strain index between male jumpers and controls. We conclude that the improvement of mechanical properties of young adult bone in response to long-term exercise is related to geometric adaptation and not to vBMD.     

Loading Mode Interactions in Simulations of Long Bone Cross-Sectional Adaptation

Although many bone adaptation theories have been formulated to address both trabecular and cortical adaptation, most applications have focused on trabecular adaptation. Thus far, no thorough investigations of the influence of different types of loading on predicted patterns of long bone cross-sectional adaptation have been reported. In the current study, we present a new model for long bone cross-sectional adaptation that incorporates axial, bending and torsional loading components. We found that bending moments have a strong potential to modulate cross-sectional geometry, but can produce unforseen (and unrealistic) geometric instabilities. Torsional moments have the ability to suppress these instabilities, suggesting that torsion may play a more significant role in guiding long bone development than previously recognized. Our results also call into question the concept of strict "remodeling equilibrium," suggesting that long bones do not necessarily approach a state of uniform mechanical stimulation. This modeling approach provides an additional perspective on experimental studies, and may lead to a greater understanding of the interaction between mechanics and biology in long bone adaptation.     

Loading Mode Interactions in Simulations of Long Bone Cross-Sectional Adaptation

Although many bone adaptation theories have been formulated to address both trabecular and cortical adaptation, most applications have focused on trabecular adaptation. Thus far, no thorough investigations of the influence of different types of loading on predicted patterns of long bone cross-sectional adaptation have been reported. In the current study, we present a new model for long bone cross-sectional adaptation that incorporates axial, bending and torsional loading components. We found that bending moments have a strong potential to modulate cross-sectional geometry, but can produce unforseen (and unrealistic) geometric instabilities. Torsional moments have the ability to suppress these instabilities, suggesting that torsion may play a more significant role in guiding long bone development than previously recognized. Our results also call into question the concept of strict “remodeling equilibrium,” suggesting that long bones do not necessarily approach a state of uniform mechanical stimulation. This modeling approach provides an additional perspective on experimental studies, and may lead to a greater understanding of the interaction between mechanics and biology in long bone adaptation.     

Peripheral quantitative computed tomography of the proximal radius in young subjects--new reference data and interpretation of results

The aim of this contribution is to provide reference data for peripheral quantitative computed tomography (Stratec XCT2000) performed at the proximal radius (the so-called '65% site') of young subjects and to discuss the interpretation of such analyses. Data from a previous reference data study on 469 subjects between 6 and 40 years were re-analyzed and smooth curves were fitted. The corresponding equations allow for calculation of age-, height- and sex-specific z-scores of total cross-sectional area, cortical cross-sectional area, bone mineral content, cortical bone mineral density, total bone mineral density, Strength-Strain Index, muscle cross-sectional area and the ratio between bone mineral content and muscle cross-sectional area. These data should facilitate the clinical use of peripheral quantitative computed tomography in young subjects.     

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.

     

Determination of mechanical stiffness of bone by pQCT measurements: correlation with non-destructive mechanical four-point bending test data

Mechanical tests of bone provide valuable information about material and structural properties important for understanding bone pathology in both clinical and research settings, but no previous studies have produced applicable non-invasive, quantitative estimates of bending stiffness. The goal of this study was to evaluate the effectiveness of using peripheral quantitative computed tomography (pQCT) data to accurately compute the bending stiffness of bone. Normal rabbit humeri (N=8) were scanned at their mid-diaphyses using pQCT. The average bone mineral densities and the cross-sectional moments of inertia were computed from the pQCT cross-sections. Bending stiffness was determined as a function of the elastic modulus of compact bone (based on the local bone mineral density), cross-sectional moment of inertia, and simulated quasistatic strain rate. The actual bending stiffness of the bones was determined using four-point bending tests. Comparison of the bending stiffness estimated from the pQCT data and the mechanical bending stiffness revealed excellent correlation (R2=0.96). The bending stiffness from the pQCT data was on average 103% of that obtained from the four-point bending tests. The results indicate that pQCT data can be used to accurately determine the bending stiffness of normal bone. Possible applications include temporal quantification of fracture healing and risk management of osteoporosis or other bone pathologies.     

Cortical bone measurements in Turner's syndrome.

Cortical bone width measurements taken at midshaft on the second metacarpal were obtained from 156 hand X-rays of 80 karyotypically documented individuals with Turner's syndrome age 1 to 25 years. Total shaft width, medullary width, cortical width and percent cortical area were grouped by bone age and compared with normal female standards. Total width was significantly and increasingly below normal; medullary width was not consistently different from normal; cortical width was significantly lower from normal from age 14 onward, although it did rise at age 17 (adult bone age); percent cortical area was significantly below normal at ages 14 and 15, but was normal by adulthood. Values for percent cortical area did not indicate severe or widespread osteoporosis. Within the Turners sample cortical bone measurement were not significantly decreased in the presence of the XO sex chromosome constitution compared with other sex chromosome variants. Nor were the measurements decreased in the presence of positive metacarpal sign or a combination of typical Turner stigmata (web neck, low posterior hairline, shield chest). There was evidence that cortical width and percent cortical area increased significantly following estrogen treatment or spontaneous menarche.     

Bone size and mechanics at the femoral diaphysis across age and sex

The reasons for the increase in fracture rates with age are not fully understood. It is known that there is a decrease in bone mass with a presumed loss of strength. This decrease may possibly be compensated for by changes in cross-sectional geometry. Previous studies, which have been limited by lack of information on subjects’ heights and weights, were not able to resolve this issue. In this study, measurements of cross-sectional geometry (area and second moments of area) from 107 specimens of human femoral diaphysis from subjects aged 21–92 years were analysed. Mathematical models of the variation in bone geometry with age were developed. These models included the effects of sex, height and weight. Values of parameters from these models were then used in a biomechanical analysis of the static stresses at the mid-shaft of the femur. Results indicate that although there was a reduction in cortical area in old age, bone tissue was redistributed so that neither bending stresses in the coronal plane nor torsional stresses were higher in old age than in young adulthood. An additional finding was that at any age women had smaller bones, less cortical bone area and higher bone stresses than men. This finding may have some bearing on the higher fracture incidence seen in older women.