Artificial composite bone as a model of human trabecular bone: the implant-bone interface

The use of artificial bones in implant testing has become popular due to their low variability and ready availability. However, friction coefficients, which are critical to load transfer in uncemented implants, have rarely been compared between human and artificial bone, particularly for wet and dry conditions. In this study, the static and dynamic friction coefficients for four commercially used titanium surfaces (polished, Al(2)O(3) blasted, plasma sprayed, beaded) acting on the trabecular component of artificial bones (Sawbones) were compared to those for human trabecular bone. Artificial bones were tested in dry and wet conditions and normal interface stress was varied (0.25, 0.5, 1.0MPa). Friction coefficients were mostly lower for artificial bones than real bone. In particular, static friction coefficients for the dry polished surface were 20% of those for real bone and 42-61% for the dry beaded surface, with statistical significance (alpha<0.05). Less marked differences were observed for dynamic friction coefficients. Significant but non-systematic effects of normal stress or wet/dry condition on friction coefficients were observed within each surface type. These results indicate that the use of artificial bone models for pre-clinical implant testing that rely on interface load transfer with trabecular bone for mechanical integrity can be particularly sensitive to surface finish and lubrication conditions.     

Improvements in dehydration and cement line staining for methacrylate embedded human bone biopsies

Undemineralized methacrylate embedded bone biopsies and other bone specimens can be processed much more rapidly by application of acidified 2,2-dimethoxypropane (DMP) dehydration, which requires two hours, than by traditional graded ethanol dehydration, which requires at least four days. This shortened processing time is valuable when biopsy results are urgently needed to detect osteomalacia or to determine bone features prior to possible parathyroidectomy. We have processed over 200 bone specimens with DMP and have compared DMP dehydration to graded ethanol dehydration in 11 biopsies in which two plugs were available from the same patient. DMP dehydration does not compromise the following: tetracycline retention, Goldner's stain, acid phosphatase localization or histochemical identification of aluminum. Cement lines, which provide a record of past remodelling, are useful in clinical interpretation of bone biopsies. We have adapted two stains, toluidine blue and methylene blue/basic fuchsin, for improved cement line identification. Five-micrometer sections individually demineralized in acetate buffer prior to cement line staining show best results with toluidine blue at pH 5.5 and with methylene blue/basic fuchsin at pH 2.5-3.5.     

Early cement damage around a femoral stem is concentrated at the cement/bone interface

This study aimed to improve understanding of the mechanical aspects of cemented implant loosening. After aggressive fatigue loading of stem/cement/femur constructs, micro-cracks and stem/bone micro-motions were quantified to answer three research questions: Are cracks preferentially associated with the stem/cement interface, the cement/bone interface or voids? Is cement damage dependent on axial position? Does cement damage correlate with micro-motion between the stem and the bone? Eight Charnley Cobra stems were implanted in cadaveric femora. Six stem/cement/femur constructs were subjected to "stair-climbing" loads for 300 kcycles at 2Hz. Loads were normalized by construct stiffness to avoid fracture. Two additional constructs were not loaded. Transverse sections were cut at 10mm intervals, stained with a fluorescent dye penetrant and examined using epi-fluorescence stereomicroscopy. Crack lengths and cement areas were recorded for 9 sections per specimen. Crack length-density was calculated by dividing summed crack length by cement mantle area. To isolate the effect of loading, length-density data were offset by the baseline length-density measured in the non-loaded specimens. Significantly more cracks were associated with the interdigitated area (35.1%+/-11.6%) and the cement/bone interface (31.0%+/-6.2%) than with the stem/cement interface (11.0%+/-5.2%) or voids (6.1%+/-4.8%) (p<0.05). Load-induced micro-crack length-density was significantly dependent on axial position, increasing proximally (p<0.001). Micro-motions were small, all stems rotated internally. Cement damage did not correlate with micro-motion.     

Thermal analysis of bone cement polymerisation at the cement-bone interface

The two major problems that have been reported with the use of polymethylmethacrylate (PMMA) cement are thermal necrosis of surrounding bone due to the high heat generation during polymerisation and chemical necrosis due to unreacted monomer release. Computer models have been used to study the temperature and monomer distribution after cementation. In most of these models, however, polymerisation is modelled as temperature independent and cancellous bone is modelled as a continuum. Such models thus cannot account for the expected important role of the trabecular bone micro-structure. The aim of this study is to investigate the distribution of temperature and monomer leftover at the cancellous bone–cement interface during polymerisation for a realistic trabecular bone—cement micro-structure and realistic temperature-dependent polymerisation kinetics behaviour.

A 3-D computer model of a piece of bovine cancellous bone that underwent pressurization with bone–cement was generated using a micro-computed tomography scanner. This geometry was used as the basis for a finite element model and a temperature-dependent problem for bone cement polymerisation kinetics was solved to simulate the bone cement polymerisation process in the vicinity of the interface. The transient temperature field throughout the interface was calculated, along with the polymerisation fraction distribution in the cement domain.

The calculations revealed that the tips of the bone trabeculae that are embedded in the cement attain temperatures much higher than the average temperature of the bone volume. A small fraction of the bone (10%) is exposed to temperatures exceeding 70°C, but the exposure time to these high temperatures is limited to 50 s. In the region near the bone, the cement polymerisation fraction (about 84%) is less than that in the centre (where it is reaching values of over 96%). An important finding of this study thus is the fact that the bone tissue that is subjected to the highest temperatures is also subjected to high leftover monomer concentration. Furthermore the maximum bone temperature is reached relatively early, when monomer content in the neighbouring cement is still quite high.     

Orientation of bone mineral and its role in the anisotropic mechanical properties of bone--transverse anisotropy

An orientation of hydroxyapatite (HAP) crystals in bovine femur mineral was investigated by means of X-ray pole figure analysis (XPFA). It was found that the c-axis of HAP generally orients parallel to the longitudinal axis of bone (bone axis) and a significant amount of c-axis was oriented in other directions, in particular, perpendicular to the bone axis. Comparing these results with those of the small angle X-ray scattering (SAXS) investigation by Matsushima et al. (Jap. J. appl. Phys. 21, 186-189, 1982) at least two types of morphology of bone mineral were found; rod like bone mineral having the c-axis of HAP crystal parallel to the longitudinal axis of the rod and that having the c-axis not parallel, in a particular case, perpendicular to its longitudinal axis. Transverse anisotropy in mechanical properties of bone was reproduced by the estimation of Young's moduli by using the structural results mainly from XPFA. It is concluded that the anisotropy in mechanical properties of bone is well explained by taking account of the non-longitudinal (off-bone) axial distribution of orientation of bone mineral.     

Optimization of a biomimetic bone cement: role of DCPD

We previously proposed a biomimetic α-tricalcium phosphate (α-TCP) bone cement where gelatin controls the transformation of α-TCP into calcium deficient hydroxyapatite (CDHA), leading to improved mechanical properties. In this study we investigated the setting and hardening processes of biomimetic cements containing increasing amounts of CaHPO₄·2H₂O (DCPD) (0, 2.5, 5, 10, 15 wt.%), with the aim to optimize composition. Both initial and final setting times increased significantly when DCPD content accounts for 10 wt.%, whereas cements containing 15 wt.% DCPD did not set at all. Differential scanning calorimetry (DSC), X-ray diffraction (XRD), thermogravimetry (TG) and scanning electron microscopy (SEM) investigations were performed on samples maintained in physiological solution for different times. DCPD dissolution starts soon after cement preparation, but the rate of transformation decreases on increasing DCPD initial content in the samples. The rate of α-TCP to CDHA conversion during hardening decreases on increasing DCPD initial content. Moreover, the presence of DCPD prevents gelatin release during hardening. The combined effects of gelatin and DCPD on the rate of CDHA formation and porosity lead to significantly improved mechanical properties, with the best composition displaying a compressive strength of 35 MPa and a Young modulus of 1600 MPa.     

On the mechanical characterization of compact bone structure using the homogenization theory

In a previous paper (Crolet et al., 1993, J. Biomechanics 26, 677–687), a modelling of the mechanical behavior of compact bone was presented, in which the homogenization theory was the basic tool of computation. In this simulation, approximations were used for the modelling of the lamellae and the osteons: the lamella and the osteon were divided into cylindrical sectors, each sector being approximated as a parallelepiped having a periodic structure (fibrous composite for the lamella, superimposition of plates for the osteon). The present study deals with a new model without these approximations. First, it can be proved that the homogenized elasticity tensor for a lamella, which has a non-periodic structure, is obtained at each geometrical point as a homogenized tensor of a periodic problem. Similarly, for the osteonal structure, the components of the homogenized tensor are determined at each point as the result of a periodic homogenization.

The software OSTEON, which is the computational method associated with this model, allows one to obtain a better understanding of the effects of many bony parameters. The obtained results are in accordance with experimental data.     

Passive mechanical properties of the lumbar multifidus muscle support its role as a stabilizer

The purpose of this study was to compare the passive mechanical properties and titin isoform sizes of the multifidus, longissimus, and iliocostalis muscles. Given our knowledge of each muscle's architecture and the multifidus’ operating range, we hypothesized that multifidus would have higher elastic modulus with corresponding smaller titin isoforms compared to longissimus or iliocostalis muscles. Single-fiber and fiber-bundle material properties were derived from passive stress–strain tests of excised biopsies (n=47). Titin isoform sizes were quantified via sodium dodecyl sulfate-vertical agarose gel electrophoresis (SDS-VAGE) analysis. We found that, at the single-fiber level, all muscles had similar material properties and titin isoform sizes. At the fiber-bundle level, however, we observed significantly increased stiffness (～45%) in multifidus compared to longissimus and iliocostalis muscles. These data demonstrate that each muscle may have a different scaling relationship between single-fiber and fiber-bundle levels, suggesting that the structures responsible for higher order passive mechanical properties may be muscle specific. Our results suggest that divergent passive material properties are observed at size scales larger than the single cell level, highlighting the importance of the extracellular matrix in these muscles. In addition to architectural data previously reported, these data further support the unique stabilizing function of the multifidus muscle. These data will provide key input variables for biomechanical modeling of normal and pathologic lumbar spine function and direct future work in biomechanical testing in these important muscles.     

Material changes in osteoporotic human cancellous bone following infiltration with acrylic bone cement for a vertebral cement augmentation

Bone cement infiltration can be effective at mechanically augmenting osteoporotic vertebrae. While most published literature describes the gain in mechanical strength of augmented vertebrae, we report the first measurements of viscoelastic material changes of cancellous bone due to cement infiltration. We infiltrated cancellous core specimen harvested from osteoporotic cadaveric spines with acrylic bone cement. Bone specimen before and after cement infiltration were subjected to identical quasi-static and relaxation loading in confined and free compression. Testing data were fitted to a linear viscoelastic model of compressible material and the model parameters for cement, native cancellous bone, and cancellous bone infiltrated (composite) with cement were identified. The fitting demonstrated that the linear viscoelastic model presented in this paper accurately describes the mechanical behaviour of cement and bone, before and after infiltration. Although the composite specimen did not completely adopt the properties of bulk bone cement, the stiffening of cancellous bone due to cement infiltration is considerable. The composite was, for example, 8.5 times stiffer than native bone. The local stiffening of cancellous bone in patients may alter the load transfer of the augmented motion segment and may be the cause of subsequent fractures in the vertebrae adjacent to the ones infiltrated with cement. The material model and parameters in this paper, together with an adequate finite-element model, can be helpful to investigate the load shift, the mechanism for subsequent fractures, and filling patterns for ideal cement infiltration.     

The mechanical properties of human tibial trabecular bone as a function of metaphyseal location

Experimental determination of the elastic modulus and ultimate strength of human tibial trabecular bone as a function of metaphyseal location is presented.

A 1 cm cubic matrix with planes parallel to the subchondral plate was defined on five fresh frozen cadaver tibias. Approximately 400, 7 mm × 10 mm cylindrical bone plugs were cut from the locations defined by the matrix and tested in uniaxial compressive stress at a strain rate of 0.1%s⁻¹. Results of the study indicate that the trabecular bone properties vary as much as two orders of magnitude from one location to another. As might be predicted from Wolff's law, and noted by previous investigators, concentrations of strength arise from the medial and lateral metaphyseal cortices toward the major medial and lateral contact regions.

These results may be valuable for improved analytical modeling and optimal prosthetic design.     

Density of fresh and embalmed human compact and cancellous bone

This investigation was undertaken to determine the densities of fresh human compact and cancellous bone, with its marrow constituents intact, and compact and cancellous bone taken from embalmed cadavers. The density of 107 bone specimens was determined on the basis of the weight and volume of each specimen. Mean density results were: (1) fresh compact bone, 1.85; (2) fresh cancellous bone, 1.08; (3) embalmed compact bone, 1.85; and (4) embalmed cancellous bone, 1.09. Embalming did not appear to have altered the density of either compact or cancellous bone. It was observed also that the densities of several bone specimens taken from the same area of one bone varied greatly.     

Temperature and angiogenesis: the possible role of mechanical factors in capillary growth

This review examines the effect of prolonged cold exposure on muscle capillary supply in mammals and fishes. In rats and hamsters, the response to a simulated onset of winter is to conserve the microcirculation and maintain a constant capillary to fibre ratio (C:F), implying either an unaltered vacular bed or angiogenesis matched by muscle hyperplasia, while chronic acclimation to low environmental temperature induces a variable degree of muscle atrophy, which in turn increases capillary density (CD). In striped bass and rainbow trout, cold-induced angiogenesis results in an increase in C:F, but also a cold-induced fibre hypertrophy that is accompanied by a powerful angiogenic response such that CD is much less sensitive to changes in fibre size. Endothelial cells can act as mechanotransducers such that angiogenesis may be initiated by changes in their physical environment. It is hypothesised that in mammals, the metabolic consequences of cold exposure increases the luminal shear stress, while in fishes the stimulus for angiogenesis is abluminal stretch following an increase in fibre size.     

Oestrogen conjugation in mid trimester human fetal brain: a possible role in its sexual differentiation

Mid-trimester human fetal brain cytosol incubated with [3H]-oestradiol gave a radioactive peak on 5% polyacrylamide gels, which migrated with the bromophenol blue marker (anodic peak) and which could be suppressed by the addition of 100 times molar excess of unlabelled ligand to the incubate. This anodic peak could only be destroyed by proteolytic enzymes if they were added at the beginning of the incubation, but not subsequently, indicating that it did not represent a protein-bound oestradiol. Competition studies show that the anodic peak can be suppressed with natural oestrogens and ethinyloestradiol, but not by the synthetic oestrogens, androgens and progestins tested. Butanol extraction of incubates, followed by t.l.c. in a number of systems, indicates that both oestrone and oestradiol are sulphated. The parent steroids could be liberated by hydrolysis of incubates with either 1N sulphuric acid or aryl sulphatase. This conjugation may effectively curtail the action in fetal tissues of high levels of oestrogens and hence play a role in brain sexual differentiation in the human.