Cancellous bone mechanical properties from normals and patients with hip fractures differ on the structure level, not on the bone hard tissue level

被引:139
作者
Homminga, J
McCreadie, BR
Ciarelli, TE
Weinans, H
Goldstein, SA
Huiskes, R
机构
[1] Eindhoven Univ Technol, Fac Biomed Engn, NL-5600 MB Eindhoven, Netherlands
[2] Univ Nijmegen, Orthoped Res Lab, Nijmegen, Netherlands
[3] Erasmus Univ, Erasmus Orthoped Res Lab, Rotterdam, Netherlands
[4] Univ Michigan, Orthoped Res Labs, Ann Arbor, MI 48109 USA
关键词
cancellous bone; tissue mechanical properties; apparent mechanical properties; osteoporosis; fracture risk;
D O I
10.1016/S8756-3282(02)00693-2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Osteoporosis is currently defined in terms of low bone mass. However, the source of fragility leading to fracture has not been adequately described. In particular, the contributions of bone tissue properties and architecture to the risk or incidence of fracture are poorly understood. In an earlier experimental study, it was found that the architectural anisotropy of cancellous bone from the femoral heads of fracture patients was significantly increased compared with age- and density-matched control material (Ciarelli et al., J Bone Miner Res 15:32-40; 2000). Using a combination of compression testing and micro-finite element analysis on a subset of cancellous bone specimens from that study, we calculated the hard tissue mechanical properties and the apparent (macroscopic) mechanical properties. The tissue modulus was 10.0 GPa (SD 2.2) for the control group and 10.8 GPa (SD 3.3) for the fracture group (not significant). There were no differences in either the apparent yield strains, percentages of highly strained tissue, or the relationship between apparent yield stress and apparent elastic modulus. Hence, a difference in the tissue yield properties is unlikely. At the apparent level, the fracture group had a significantly decreased transverse stiffness, resulting in increased mechanical anisotropy. These changes suggest that bone in the fracture group was "overadapted" to the primary load axis, at the cost of fragility in the transverse direction. We conclude that individuals with a history of osteoporotic fractures do not have weaker bone tissue. Architectural and mechanical anisotropy alone renders their bone weaker in the nonprimary loading direction. (C) 2002 by Elsevier Science Inc. All rights reserved.
引用
收藏
页码:759 / 764
页数:6
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