Mechanical Characterization of Fourth Generation Composite Humerus

Mechanical data on upper extremity surrogate bones, supporting use as biomechanical tools, is limited. The objective of this study was to characterize the structural behaviour of the fourth-generation composite humerus under simulated physiologic bending, specifically, stiffness, rigidity, and mid-diaphysial surface strains. Three humeri were tested in four-point bending, in anatomically defined anteroposterior (AP) and mediolateral (ML) planes. Stiffness and rigidity were derived using load–displacement data. Principal strains were determined at the anterior, posterior, medial, and lateral surfaces in the humeral mid-diaphysial transverse plane of one specimen using stacked rosettes. Linear structural behaviour was observed within the test range. Average stiffness and rigidity were greater in the ML (918 ± 18 N/mm; 98.4 ± 1.9 Nm2) than the AP plane (833 ± 16 N/mm; 89.3 ± 1.6 Nm2), with little inter-specimen variability. The ML/AP rigidity ratio was 1.1. Surface principal strains were similar at the anterior (5.41 µε/N) and posterior (5.43 µε/N) gauges for AP bending, and comparatively less for ML bending, i.e. 5.1 and 4.5 µε/N, at the medial and lateral gauges, respectively. This study provides novel strain and stiffness data for the fourth-generation composite humerus and also adds to published construct rigidity data. The presented results support the use of this composite bone as a tool for modelling and experimentation

Material and Structural Aspects of Bone in Osteogenesis Imperfecta

Bone fragility is a fundamental problem in individuals with osteogenesis imperfecta (OI). The mechanisms behind this fragility, however, are not yet well understood. Multiple factors appear to contribute to the increased fracture risk in OI. At the structural level, bone mass deficiency can result in increased stress levels within bones. The underlying mineral and collagen abnormalities that define OI are also believed to result in compromised material-level properties. The variability of collagen biochemical irregularities causing OI and the corresponding heterogeneity of disease severity result in abnormalities that are not easily generalized within the OI population. The aims of this chapter are to introduce basic mechanical notions pertaining to the strength of structures and materials, and to present a synthesis of existing literature regarding the mechanical properties of bones in OI

Macroscopic Anisotropic Bone Material Properties in Children with Severe \u3cem\u3eOsteogenesis imperfecta\u3c/em\u3e

Children with severe osteogenesis imperfecta(OI) typically experience numerous fractures and progressive skeletal deformities over their lifetime. Recent studies proposed finite element models to assess fracture risk and guide clinicians in determining appropriate intervention in children with OI, but lack of appropriate material property inputs remains a challenge. This study aimed to characterize macroscopic anisotropic cortical bone material properties and investigate relationships with bone density measures in children with severe OI. Specimens were obtained from tibial or femoral shafts of nine children with severe OI and five controls. The specimens were cut into beams, characterized in bending, and imaged by synchrotron radiation X-ray micro-computed tomography. Longitudinal modulus of elasticity, yield strength, and bending strength were 32–65% lower in the OI group (p \u3c 0.001). Yield strain did not differ between groups (p ≥ 0.197). In both groups, modulus and strength were lower in the transverse direction (p ≤ 0.009), but anisotropy was less pronounced in the OI group. Intracortical vascular porosity was almost six times higher in the OI group (p \u3c 0.001), but no differences were observed in osteocyte lacunar porosity between the groups (p = 0.086). Volumetric bone mineral density was lower in the OI group (p \u3c 0.001), but volumetric tissue mineral density was not (p = 0.770). Longitudinal OI bone modulus and strength were correlated with volumetric bone mineral density (p ≤ 0.024) but not volumetric tissue mineral density (p ≥ 0.099). Results indicate that cortical bone in children with severe OI yields at the same strain as normal bone, and that their decreased bone material strength is associated with reduced volumetric bone mineral density. These results will enable the advancement of fracture risk assessment capability in children with severe OI

Recent Developments in Osteogenesis Imperfecta

Osteogenesis imperfecta (OI) is an uncommon genetic bone disease associated with brittle bones and fractures in children and adults. Although OI is most commonly associated with mutations of the genes for type I collagen, many other genes (some associated with type I collagen processing) have now been identified. The genetics of OI and advances in our understanding of the biomechanical properties of OI bone are reviewed in this article. Treatment includes physiotherapy, fall prevention, and sometimes orthopedic procedures. In this brief review, we will also discuss current understanding of pharmacologic therapies for treatment of OI

Micro-CT Characterization of Human Trabecular Bone in Osteogenesis Imperfecta

Osteogenesis imperfecta (OI) is a genetic syndrome affecting collagen synthesis and assembly. Its symptoms vary widely but commonly include bone fragility, reduced stature, and bone deformity. Because of the small size and paucity of human specimens, there is a lack of biomechanical data for OI bone. Most literature has focused on histomorphometric analyses, which rely on assumptions to extrapolate 3-D properties. In this study, a micro-computed tomography (μCT) system was used to directly measure structural and mineral properties in pediatric OI bone collected during routine surgical procedures. Surface renderings suggested a poorly organized, plate-like orientation. Patients with a history of bone-augmenting drugs exhibited increased bone volume fraction (BV/TV), trabecular number (Tb.N), and connectivity density (Eu.Conn.D). The latter two parameters appeared to be related to OI severity. Structural results were consistently higher than those reported in a previous histomorphometric study, but these differences can be attributed to factors such as specimen collection site, drug therapy, and assumptions associated with histomorphometry. Mineral testing revealed strong correlations with several structural parameters, highlighting the importance of a dual approach in trabecular bone testing. This study reports some of the first quantitative μCT data of human OI bone, and it suggests compelling possibilities for the future of OI bone assessment

3D Micron-scale Imaging of the Cortical Bone Canal Network in Human Osteogenesis Imperfecta (OI)

Osteogenesis imperfecta (OI) is a genetic disorder leading to increased bone fragility. Recent work has shown that the hierarchical structure of bone plays an important role in determining its mechanical properties and resistance to fracture. The current study represents one of the first attempts to characterize the 3D structure and composition of cortical bone in OI at the micron-scale. A total of 26 pediatric bone fragments from 18 individuals were collected during autopsy (Nc=5) or routing orthopaedic procedures (NOI=13) and imaged by microtomography with a synchrotron light source (SRµCT) for several microstructural parameters including cortical porosity (Ca.V/TV), canal surface to tissue volume (Ca.S/TV), canal diameter (Ca.Dm), canal separation (Ca.Sp), canal connectivity density (Ca.ConnD), and volumetric tissue mineral density (TMD). Results indicated significant differences in all imaging parameters between pediatric controls and OI tissue, with OI bone showing drastically increased cortical porosity, canal diameter, and connectivity. Preliminary mechanical testing revealed a possible link between cortical porosity and strength. Together these results suggest that the pore network in OI contributes greatly to its reduced mechanical properties

Design and Validation of Bending Test Method for Characterization of Miniature Pediatric Cortical Bone Specimens

Osteogenesis imperfecta is a genetic disorder of bone fragility; however, the effects of this disorder on bone material properties are not well understood. No study has yet measured bone material strength in humans with osteogenesis imperfecta. Small bone specimens are often extracted during routine fracture surgeries in children with osteogenesis imperfecta. These specimens could provide valuable insight into the effects of osteogenesis imperfecta on bone material strength; however, their small size poses a challenge to their mechanical characterization. In this study, a validated miniature three-point bending test is described that enables measurement of the flexural material properties of pediatric cortical osteotomy specimens as small as 5 mm in length. This method was validated extensively using bovine bone, and the effect of span/depth aspect ratio (5 vs 6) on the measured flexural properties was examined. The method provided reasonable results for both Young’s modulus and flexural strength in bovine bone. With a span/depth ratio of 6, the median longitudinal modulus and flexural strength results were 16.1 (range: 14.4–19.3) GPa and 251 (range: 219–293) MPa, respectively. Finally, the pilot results from two osteotomy specimens from children with osteogenesis imperfecta are presented. These results provide the first measures of bone material strength in this patient population