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R Huiskes

Publications and source records attributed to R Huiskes.

At least 19 recordsLinked to original sources

Introduction and evaluation of a gray-value voxel conversion technique.

In micro finite element analyses (microFEA) of cancellous bone, the 3D-imaging data that the FEA-models are based on, contain a range of gray-values. In the construction of the eventual FEA-model, these gray-values are commonly thresholded. Although thresholding is successful at small voxel sizes, at larger voxel sizes there is substantial loss of trabecular connectivity. We propose a new method: the gray-value method, where the microFEA-models use the information within the 3D-imaging data directly, without prior thresholding. Our question was twofold. First, how does the gray-value method compare to both plain and mass-compensated thresholding? Second, what is the effect of element size on the results obtained with the gray-value method? We used nine microCT-scans of human vertebral cancellous bone. These were degraded to represent different resolutions, and converted into microFEA-models using plain thresholding, mass-compensated thresholding, and the gray-value method. The apparent elastic moduli of the specimens were determined using microFEA. The different methods were compared on the basis of the apparent elastic moduli, compared to those calculated for a 28 microm reference model. The results showed that the gray-value method greatly improves the results relative to other methods. The gray-value method gives accurate predictions of the apparent elastic moduli, for voxel sizes up to one trabecular thickness (Tb.Th.). For voxel sizes greater than one Tb.Th. the accuracy, although still better than for both thresholding methods, becomes increasingly worse.

Biomechanical Phenomena↗

Stress distribution changes in bovine vertebrae just below the endplate after sustained loading.

OBJECTIVE: To describe the pattern of stress distribution in the vertebral body just behind the endplate, and to document its changes due to sustained loading. METHODS: Twelve fresh bovine coccygeal motion segments were dissected and tested. Each specimen was axially loaded with a sustained compressive force of 50% of its estimated compressive strength. Before loading, after 1.5 h and after 3 h of loading, the distribution of the axial pressure under the bottom vertebra (i.e., just below its top endplate) was recorded at three force levels (25%, 37.5% and 50% of the estimated compressive strength), using pressure-sensitive film. RESULTS: Stress distribution over the endplate was found to be fairly uniform. At low compression forces, the stress was the highest centrally. With increased compression and after sustained compression the uniformity improved through a significant redistribution of stress to the periphery. No stress peaks were found to occur after sustained loading. CONCLUSION: Stress peaks after sustained loading cannot explain the occurrence of endplate fractures in sustained cyclic compression in non-degenerated discs. Competing explanations, such as creep, and fatigue failure, would appear more likely candidates. RELEVANCE: It has been hypothesised that compression induced fractures of the lumbar vertebral endplate constitute an important etiological factor for low back pain. Competing theories exist on the fracture mechanism in sustained loading and these would have different implications with respect to prevention. The present study evaluated one of these theories.

Analysis of Variance↗

The prospects of estimating trabecular bone tissue properties from the combination of ultrasound, dual-energy X-ray absorptiometry, microcomputed tomography, and microfinite element analysis.

Osteoporosis commonly is assessed by bone quantity, using bone mineral density (BMD) measurements from dual-energy X-ray absorptiometry (DXA). However, such a measure gives neither information about the integrity of the trabecular architecture nor about the mechanical properties of the constituting trabeculae. We investigated the feasibility of deriving the elastic modulus of the trabeculae (the tissue modulus) from computer simulation of mechanical testing by microfinite element analysis (muFEA) in combination with measurements of ultrasound speed of sound (SOS) and BMD measurements. This approach was tested on 15 postmortem bovine bone cubes. The apparent elastic modulus of the specimens was estimated from SOS measurements in combination with BMD. Then the trabecular morphology was reconstructed using microcomputed tomography (muCT). From the reconstruction a mesh for muFEA was derived, used to simulate mechanical testing. The tissue modulus was found by correlating the apparent moduli of the specimens as assessed by ultrasound with the ones as determined with muFEA. A mean tissue modulus of 4.5 GPa (SD, 0.69) was found. When adjusting the muFEA-determined elastic moduli of the entire specimens with their calculated tissue modulus, an overall correlation of R2 = 96% with ultrasound-predicted values was obtained. We conclude that the apparent elastic stiffness characteristics as determined from ultrasound correlate linearly with those from muFEA. From both methods in combination, the elastic stiffness of the mineralized tissue can be determined as an estimator for mechanical tissue quality. This method can already be used for biopsy specimens, and potentially could be applicable in vivo as well, when clinical CT or magnetic resonance imaging (MRI) tools with adequate resolution reach the market. In this way, mechanical bone quality could be estimated more accurately in clinical practice.

Absorptiometry, Photon↗

Effects of mechanical forces on maintenance and adaptation of form in trabecular bone.

The architecture of trabecular bone, the porous bone found in the spine and at articulating joints, provides the requirements for optimal load transfer, by pairing suitable strength and stiffness to minimal weight according to rules of mathematical design. But, as it is unlikely that the architecture is fully pre-programmed in the genes, how are the bone cells informed about these rules, which so obviously dictate architecture? A relationship exists between bone architecture and mechanical usage--while strenuous exercise increases bone mass, disuse, as in microgravity and inactivity, reduces it. Bone resorption cells (osteoclasts) and bone formation cells (osteoblasts) normally balance bone mass in a coupled homeostatic process of remodelling, which renews some 25% of trabecular bone volume per year. Here we present a computational model of the metabolic process in bone that confirms that cell coupling is governed by feedback from mechanical load transfer. This model can explain the emergence and maintenance of trabecular architecture as an optimal mechanical structure, as well as its adaptation to alternative external loads.

Adaptation, Physiological↗

Creep properties of three low temperature-curing bone cements: a preclinical assessment.

The mechanical characteristics of new bone cements should be assessed before these cements are released on the orthopedic market in great quantities. In this study, we present the deformational response of 3 relatively new, low-curing temperature bone cements (Cemex RX, Cemex System, and Cemex Isoplastic) to a dynamic compressive force in comparison to Simplex P bone cement. For this purpose, dynamic compressive creep tests were performed on cylindrical shaped specimens at a maximal load level of 20 MPa for a period of 250,000 cycles. The results showed that Cemex System and Cemex RX produced creep rates that were higher (20% and 30%, respectively) as compared to Simplex P bone cement. The creep behavior of Cemex Isoplastic was very similar to that of Simplex P. It was concluded that although Cemex RX and Cemex System produced higher creep rates than Simplex P, these differences were not considered excessive. Hence, although other tests are required to assess the safety and efficacy of these new cements, the dynamic creep properties under compression can be considered adequate for clinical use.

Biocompatible Materials↗

Influence of muscular activity on local mineralization patterns in metatarsals of the embryonic mouse.

This study addressed the theory that local mechanical loading may influence the development of embryonic long bones. Embryonic mouse metatarsal rudiments were cultured as whole organs, and the geometry of the primary ossification center was compared with that of rudiments that had developed in utero. The mineralization front in vivo was found to be nearly straight, whereas in vitro it acquired a more convex shape due to a slower mineralization rate at the periphery of the mineralized cylinder. A poroelastic finite element analysis was performed to calculate the local distributions of distortional strain and fluid pressure at the mineralization front in the metatarsal during loading in vivo as a result of muscle contractions in the embryonic hindlimbs. The distribution of fluid pressure from the finite element analysis could not explain the difference in mineralization shape. The most likely candidate for the difference was the distortional strain, resulting from muscle contraction, which is absent in vitro, because its value at the periphery was significantly higher than in the center of the tissue. Without external loads, the mineralization process may be considered as pre-programmed, starting at the center of the tissue and resulting in a spherical mineralization front. Strain modulates the rate of the mineralization process in vivo, resulting in the straight mineralization front. These results confirm that disturbances in muscle development are likely to produce disturbed mineralization patterns, resulting in a disordered osteogenic process.

Animals↗

Wear particle diffusion and tissue differentiation in TKA implant fibrous interfaces.

In the context of mechanical loosening, we studied the hypothesis that wear-particle migration in the fibrous membrane under tibial plateaus after total knee arthroplasty can be explained by the pumping effects of the interstitial fluid in the tissue. Further, as a secondary objective we investigated the possibility that interface-tissue differentiation is influenced by interstitial fluid flow and strain, as mechanical effects of interface motions. For comparative reasons, we analyzed a previously published simplified two-dimensional finite-element model, this time assuming biphasic tissue properties. We wanted to determine hydrostatic pressure and flow velocities in the fluid phase, in addition to stresses and strains, for time-dependent loading of the plateau. We found that fluid flow in the interface was extremely slow, except in the periphery. Hence, loosening due to particle-induced bone resorption appears improbable. The results, however, do support the idea that particles migrate with fluid flow, when such flow occurs. Where fibrous tissue tends to be prominent in reality, the fluid is repeatedly extruded and reabsorbed in the model. Where these values are low, fibrocartilage is commonly found. When material properties were varied to subsequently represent fibrocartilage and two stages of mineralization, the strains and fluid velocities is reduced. Fluid pressure, however, did not change. Our results refute the hypothesis that wear particles are pumped through the interface tissue below a TKA but support the hypothesis that interface tissue type and loosening processes are influenced by mechanical tissue variables such as tissue strain and interstitial fluid velocity.

Biomechanical Phenomena↗

Incorporation of morsellized bone graft under controlled loading conditions. A new animal model in the goat.

The aim of this study was to develop a new animal model in which we could assess the in vivo effects of mechanical stimuli in the incorporation process of impacted morsellized bone grafts. The subcutaneous pressure implant SPI was developed for use in the goat. This device can generate controlled loading conditions onto a fixed amount of bone graft in the distal femur. Twenty goats were divided into three groups: non-loaded, 2 or 4 MPa loads (1 Hz, 1 h/day). The goats were sacrificed after 3, 6 or 12 weeks. The results were documented by clinical observations, quantitative bone density from QCT-scanning and histomorphometry. Nine post-mortem knee specimens were prepared in a similar manner to the experimental knees to determine the reproducibility and mechanical stability of the grafting method. Three goats were lost due to complications, the others functioned clinically well. Histology showed invasion of the bone graft by a front of vascular fibrous tissue after which osteoclasts resorbed the dead bone graft, followed by woven bone apposition on the graft remnants. At 12 weeks the loaded grafts had transformed into a vital trabecular structure. QCT bone density measurements revealed persistently high densities in the 12-weeks 4 MPa specimens, but reduced densities in the 2 MPa and non-loaded specimens. Morphometrically, the mineralising surface was larger in the 4 MPa group (P = 0.02) and the incorporation and remodelling processes had advanced more rapidly in the 2 MPa specimens (P = 0.04). Although the numbers investigated in this study in each group were low, statistical differences were found in the amount of graft left after incorporation and in the apposition rate of the new bone. In the future this model will be used to study the incorporation potential of different types of bone graft and bone graft substitutes.

Animals↗

Effects of hormonal conditions and drugs on both muscle and bone strength can be assessed in a single rat test.

Strength of both muscles and bone are important for fracture prevention in osteoporotic individuals. Therefore, drugs that are preclinically tested in animals for preventing or treating osteoporosis, and reducing fracture risk, should not only be checked for their effects on bone strength, but also for those on muscle strength. We developed a rat model to measure both in the same animal, using a single test. The model is based on an in vivo, ventral three-point bending test of the lower leg (Nordsletten L. and Ekeland A. J Orthop Res 11:299-304; 1993). This model was developed to test the contribution of triceps surae muscle contraction to the strength of the tibia. We hypothesized that this same test can be applied to determine bone and muscle strength independently, in an absolute sense. To investigate this possibility, the muscle contribution to bone stresses was estimated from mechanical analyses, based on direct assessment of muscle strength in a separate test. Sixteen mature female Wistar rats were used, half of which were ovariectomized. After 12 weeks, the rats were tested in vivo in three-point bending of the right lower leg during muscle contraction, and then the isolated triceps surae muscle strength in the left lower leg was measured separately, in another model. The rats were then killed, and the left nude shafts were tested mechanically in three-point bending in vitro to determine structural strength of the bone alone. Ultimate external bending moments of the in vivo and in vitro tests, maximal muscle force, and geometrical parameters formed the basis for the analysis. While contracting, the triceps surae loads the tibia in axial compression and bending. We found that the axial compressive stress on the bone due to muscle contraction was less than 2.5% of the bending stress this produced. This indicates that muscle contribution to lower leg strength is due almost entirely to the bending moment it produces, counteracting the external moment put on the leg by the testing device. Thus, the difference between the in vivo (lower leg) and in vitro (nude tibia) failure bending moments is approximately equal to the maximal muscle bending moment. This information can be applied to test the effects of hormonal conditions and drugs on both muscle and bone strength independently, in a single rat test, using the aforementioned procedure.

Animals↗

Speed of sound reflects Young's modulus as assessed by microstructural finite element analysis.

We analyzed the ability of the quantitative ultrasound (QUS) parameter, speed of sound (SOS), and bone mineral density (BMD), as measured by dual-energy X-ray absorptiometry (DXA), to predict Young's modulus, as assessed by microstructural finite element analysis (muFEA) from microcomputed tomography (muCT) reconstructions. With muFEA simulation, all bone elements in the model can be assigned the same isotropic Young's modulus; therefore, in contrast to mechanical tests, only the trabecular structure plays a role in the determination of the elastic properties of the specimen. SOS, BMD, and microCT measurements were performed in 15 cubes of pure trabecular bovine bone in three orthogonal directions: anteroposterior (AP); mediolateral (ML); and craniocaudal (CC). The anisotropy of the architecture was determined using mean intercept length (MIL) measurements. SOS, MIL, and Young's modulus (E) values were significantly different in all three directions (p < 0.001), with the highest values in the CC direction. There was a strong linear relationship between E and SOS in each of the three orthogonal directions, with r(2) being 0.88, 0.92, and 0.84 (all p < 0.0001) for the CC, ML, and AP directions, respectively. The relationship between E and BMD was less strong, with r(2) being between 0.66 and 0.85 (all p < 0.0001) in the different directions. There was also a significant, positive correlation between SOS and BMD in each of the three axes (r(2) being 0.81, 0.42, and 0.92 in the CC, ML, and AP directions, respectively; p < 0.0001). After correction for BMD, the correlations between SOS and E in each of the three directions remained highly significant (r(2) = 0.77, p < 0. 0001 for the AP direction; r(2) = 0.48, p < 0.001 for the CC direction; r(2) = 0.52, p < 0.005 for the ML direction). After correction for SOS, BMD remained significantly correlated with Young's modulus in the AP and CC directions (r(2) = 0.52, p < 0.005; r(2) = 0.30, p < 0.05, respectively), but the correlation in the ML direction was no longer statistically significant. In a stepwise regression model, E was best predicted by SOS in each of the orthogonal directions. These observations illustrate the ability of the SOS technique to assess the architectural mechanical quality of trabecular bone.

Absorptiometry, Photon↗

If bone is the answer, then what is the question?

In the 19th century, several scientists attempted to relate bone trabecular morphology to its mechanical, load-bearing function. It was suggested that bone architecture was an answer to requirements of optimal stress transfer, pairing maximal strength to minimal weight, according to particular mathematical design rules. Using contemporary methods of analysis, stress transfer in bones was studied and compared with anatomical specimens, from which it was hypothesised that trabecular architecture is associated with stress trajectories. Others focused on the biological processes by which trabecular architectures are formed and on the question of how bone could maintain the relationship between external load and architecture in a variable functional environment. Wilhelm Roux introduced the principle of functional adaptation as a self-organising process based in the tissues. Julius Wolff, anatomist and orthopaedic surgeon, entwined these 3 issues in his book The Law of Bone Remodeling (translation), which set the stage for biomechanical research goals in our day. 'Wolff's Law' is a question rather than a law, asking for the requirements of structural optimisation. In this article, based on finite element analysis (FEA) results of stress transfer in bones, it is argued that it was the wrong question, putting us on the wrong foot. The maximal strength/minimal weight principle does not provide a rationale for architectural formation or adaptation; the similarity between trabecular orientation and stress trajectories is circumstantial, not causal. Based on computer simulations of bone remodelling as a regulatory process, governed by mechanical usage and orchestrated by osteocyte mechanosensitivity, it is shown that Roux's paradigm, conversely, is a realistic proposition. Put in a quantitative regulatory context, it can predict both trabecular formation and adaptation. Hence, trabecular architecture is not an answer to Wolff's question, in the sense of this article's title. There are no mathematical optimisation rules for bone architecture; there is just a biological regulatory process, producing a structure adapted to mechanical demands by the nature of its characteristics, adequate for evolutionary endurance. It is predicted that computer simulation of this process can help us to unravel its secrets.

Animals↗

The role of femoral stem extension in total knee arthroplasty.

Although stemmed femoral components often are used in revision total knee arthroplasty, no quantitative comparison of the relative stability of a femoral component with and without a stem has been performed previously. A radiostereophotogrammetric analysis was performed to determine the influence of stem extension on mechanical stability in a laboratory experiment. In addition, the contribution of impacted morselized bone graft used for reconstruction of bone defects to stability was determined. Ten fresh frozen distal femoral specimens, of which the bone mineral density was measured, were prepared to fit a cemented femoral component with an uncemented stem. A cyclic axial load of 750 N was applied to the medial part of the femoral component. The loading test was repeated after creation of a standard, unicondylar, uncontained medial bone defect, after reconstruction of the defect with impacted morselized bone graft, after disconnecting the stem from the component, and after removal of the morselized bone graft. A significant difference was found in rotation and translation of the femoral component with the stem and after its functional removal. The femoral component rotated significantly into varus and internal rotation, and the tip of the stem translated significantly laterally after disconnection of the stem. A linear correlation between bone mineral density in the femoral neck and the radiostereophotogrammetric motion data was absent, but a bone mineral density threshold level of 0.55 g/cm2 was present, below which stability decreased considerably. Morselized bone graft provided only a minor contribution to stability compared with a stem.

Arthroplasty, Replacement, Knee↗

Autologous morsellised bone grafting restores uncontained femoral bone defects in knee arthroplasty. An in vivo study in horses.

The properties of impacted morsellised bone graft (MBG) in revision total knee arthroplasty (TKA) were studied in 12 horses. The left hind metatarsophalangeal joint was replaced by a human TKA. The horses were then randomly divided into graft and control groups. In the graft group, a unicondylar, lateral uncontained defect was created in the third metatarsal bone and reconstructed using autologous MBG before cementing the TKA. In the control group, a cemented TKA was implanted without the bone resection and grafting procedure. After four to eight months, the animals were killed and a biomechanical loading test was performed with a cyclic load equivalent to the horse's body-weight to study mechanical stability. After removal of the prosthesis, the distal third metatarsal bone was studied radiologically, histologically and by quantitative and micro CT. Biomechanical testing showed that the differences in deformation between the graft and the control condyles were not significant for either elastic or time-dependent deformations. The differences in bone mineral density (BMD) between the graft and the control condyles were not significant. The BMD of the MBG was significantly lower than that in the other regions in the same limb. Micro CT showed a significant difference in the degree of anisotropy between the graft and host bone, even although the structure of the area of the MBG had trabecular orientation in the direction of the axial load. Histological analysis revealed that all the grafts were revascularised and completely incorporated into a new trabecular structure with few or no remnants of graft. Our study provides a basis for the clinical application of this technique with MBG in revision TKA.

Animals↗

Tissue stresses and strain in trabeculae of a canine proximal femur can be quantified from computer reconstructions.

A quantitative assessment of bone tissue stresses and strains is essential for the understanding of failure mechanisms associated with osteoporosis, osteoarthritis, loosening of implants and cell-mediated adaptive bone-remodeling processes. According to Wolff's trajectorial hypothesis, the trabecular architecture is such that minimal tissue stresses are paired with minimal weight. This paradigm at least suggests that, normally, stresses and strains should be distributed rather evenly over the trabecular architecture. Although bone stresses at the apparent level were determined with finite element analysis (FEA), by assuming it to be continuous, there is no data available on trabecular tissue stresses or strains of bones in situ under physiological loading conditions. The objectives of this project were to supply reasonable estimates of these quantities for the canine femur, to compare trabecular-tissue to apparent stresses, and to test Wolff's hypothesis in a quantitative sense. For that purpose, the newly developed method of large-scale micro-FEA was applied in conjunction with micro-CT structural measurements. A three-dimensional high-resolution computer reconstruction of a proximal canine femur was made using a micro-CT scanner. This was converted to a large-scale FE-model with 7.6 million elements, adequately refined to represent individual trabeculae. Using a special-purpose FE-solver, analyses were conducted for three different orthogonal hip-joint loading cases, one of which represented the stance-phase of walking. By superimposing the results, the tissue stress and strain distributions could also be calculated for other force directions. Further analyses of results were concentrated on a trabecular volume of interest (VOI) located in the center of the head. For the stance phase of walking an average tissue principal strain in the VOI of 279 strain was found, with a standard deviation of 212 microstrain. The standard deviation depended not only on the hip-force magnitude, but also on its direction. In more than 95% of the tissue volume the principal stresses and strains were in a range from zero to three times the averages, for all hip-force directions. This indicates that no single load creates even stress or strain distributions in the trabecular architecture. Nevertheless, excessive values occurred at few locations only, and the maximum tissue stress was approximately half the value reported for the tissue fatigue strength. These results thus indicate that trabecular bone tissue has a safety factor of approximately two for hip-joint loads that occur during normal activities.

Animals↗

Why does intermittent hydrostatic pressure enhance the mineralization process in fetal cartilage?

The purpose of this study was to determine which factor is the most likely one to have stimulated the mineralization process in the in vitro experiments of Klein-Nulend et al. (Arth. Rheum., 29, 1002-1009, 1986), in which fetal cartilaginous metatarsals were externally loaded with an intermittent hydrostatic pressure, by compressing the gas phase above the culture medium. Analytical calculations excluded the possibility that the tissue was stimulated by changes in dissolved gas concentration, pH or temperature of the culture medium through compression of the gas phase. The organ culture experiments were also mechanically analyzed using a poroelastic finite element (FE) model of a partly mineralized metatarsal with compressible solid and fluid constituents. The results showed that distortional strains occurred in the region where mineralization proceeded. The value of this strain was, however, very sensitive to the value of the intrinsic compressibility modulus of the solid matrix (Ks). For realistic values of Ks the distortional strain was probably too small (about 2 microstrain) to have stimulated the mineralization. If the distortional strain was not the factor to have enhanced the mineralization process, then the only candidate variable left is the hydrostatic pressure itself. We hypothesize that the pressure may have created the physical environment enhancing the mineralization process. When hydrostatic pressure is applied, the balance of the chemical potential of water across cell membranes may be disturbed, and restored again by diffusion of ions until equilibrium is reached again. The diffusion of ions may have contributed to the mineralization process.

Animals↗

Tissue stresses and strain in trabeculae of a canine proximal femur can be quantified from computer reconstructions.

A quantitative assessment of bone tissue stresses and strains is essential for the understanding of failure mechanisms associated with osteoporosis, osteoarthritis, loosening of implants and cell- mediated adaptive bone-remodeling processes. According to Wolff's trajectorial hypothesis, the trabecular architecture is such that minimal tissue stresses are paired with minimal weight. This paradigm at least suggests that, normally, stresses and strains should be distributed rather evenly over the trabecular architecture. Although bone stresses at the apparent level were determined with finite element analysis (FEA), by assuming it to be continuous, there is no data available on trabecular tissue stresses or strains of bones in situ under physiological loading conditions. The objectives of this project were to supply reasonable estimates of these quantities for the canine femur, to compare trabecular-tissue to apparent stresses, and to test Wolff's hypothesis in a quantitative sense. For that purpose, the newly developed method of large-scale micro-FEA was applied in conjunction with micro-CT structural measurements. A three-dimensional high-resolution computer reconstruction of a proximal canine femur was made using a micro-CT scanner. This was converted to a large-scale FE-model with 7.6 million elements, adequately refined to represent individual trabeculae. Using a special-purpose FE-solver, analyses were conducted for three different orthogonal hip-joint loading cases, one of which represented the stance-phase of walking. By superimposing the results, the tissue stress and strain distributions could also be calculated for other force directions. Further analyses of results were concentrated on a trabecular volume of interest (VOI) located in the center of the head. For the stance phase of walking an average tissue principal strain in the VOI of 279 strain was found, with a standard deviation of 212 microstrain. The standard deviation depended not only on the hip-force magnitude, but also on its direction. In more than 95% of the tissue volume the principal stresses and strains were in a range from zero to three times the averages, for all hip-force directions. This indicates that no single load creates even stress or strain distributions in the trabecular architecture. Nevertheless, excessive values occurred at few locations only, and the maximum tissue stress was approximately half the value reported for the tissue fatigue strength. These results thus indicate that trabecular bone tissue has a safety factor of approximately two for hip-joint loads that occur during normal activities.

Animals↗

Correlation between pre-operative periprosthetic bone density and post-operative bone loss in THA can be explained by strain-adaptive remodelling.

Periprosthetic adaptive bone remodelling after total hip arthroplasty can be simulated in computer models, combining bone remodelling theory with finite element analysis. Patient specific three-dimensional finite element models of retrieved bone specimens from an earlier bone densitometry (DEXA) study were constructed and bone remodelling simulations performed. Results of the simulations were analysed both qualitatively and quantitatively. Patterns of predicted bone loss corresponded very well with the DEXA measurements on the retrievals. The amount of predicted bone loss, measured quantitatively by simulating DEXA on finite element models, was found to be inversely correlated with the initial bone mineral content. It was concluded that the same clinically observed correlation can therefore be explained by mechanically induced remodelling. This finding extends the applicability of numerical pre-clinical testing to the analysis of interaction between implant design and initial state of the bone.

Absorptiometry, Photon↗

The role of an effective isotropic tissue modulus in the elastic properties of cancellous bone.

Conceptually, the elastic characteristics of cancellous bone could be predicted directly from the trabecular morphology--or architecture--and by the elastic properties of the tissue itself. Although hardly any experimental evidence exists, it is often implicitly assumed that tissue anisotropy has a negligible effect on the apparent elastic properties of cancellous bone. The question addressed in this paper is whether this is actually true. If it is, then micromechanical finite element analysis (micro-FEA) models, representing trabecular architecture, using an 'effective isotropic tissue modulus' should be able to predict apparent elastic properties of cancellous bone. To test this, accurate multi-axial compressive mechanical tests of 29 whale bone specimens were simulated with specimen-specific micro-FEA computer models built from true three-dimensional reconstructions. By scaling the micro-FEA predictions by a constant tissue modulus, 92% of the variation of Young's moduli determined experimentally could be explained. The correlation even increased to 95% when the micro-FEA moduli were scaled to the isotropic tissue moduli of individual specimens. Excellent agreement was also found in the elastic symmetry axes and anisotropy ratios. The prediction of Poisson's ratios was somewhat less precise at 85% correlation. The results support the hypothesis; for practical purposes, the concept of an 'effective isotropic tissue modulus' concept is a viable one. They also suggest that the value of such a modulus for individual cases might be inferred from the average tissue density, hence the degree of mineralization. Future studies must clarify how specific the tissue modulus should be for different types of bone if adequate predictions of elastic behavior are to be made in this way.

Animals↗