In bone fracture healing, the extent to which the injured bone regains stability and strength depends on the mechanical properties of the tissues that are formed during healing. While many techniques have been used to quantify the overall mechanical behavior of fracture calluses, few data exist on the material properties of individual callus tissues. The overall goal of this study was to quantify these material properties. Nanoindentation was performed at multiple locations across thin (200mum), longitudinal sections of rat fracture callus at 35 days post fracture. Following indentation, sections were stained with alizarin red S and alcian blue to obtain semi-quantitative estimates of tissue mineral content and proteoglycan content, respectively. Indentation moduli varied over three orders of magnitude (0.61-1010MPa) throughout the callus. Much of this variation was due to the presence of multiple tissue types: the indentation moduli of granulation tissue, chondroid tissue and woven bone ranged 0.61-1.27MPa (median=0.99MPa), 1.39-4.42MPa (median=2.89MPa) and 26.92-1010.00MPa (median=132.00MPa), respectively. In regions of alizarin red staining, the indentation modulus was correlated (r=0.62, P=0.04) with stain intensity, suggesting a positive correlation between modulus and mineral content in woven bone. In addition, the indentation modulus of woven bone along the periosteal aspect of the cortex increased with distance from the fracture gap (P=0.004). These results demonstrate the usefulness of nanoindentation in characterizing the elastic properties of the heterogeneous mixture of tissues present in bone fracture callus.

Defining how mechanical cues regulate tissue differentiation during skeletal healing can benefit treatment of orthopaedic injuries and may also provide insight into the influence of the mechanical environment on skeletal development. Different global (i.e., organ-level) mechanical loads applied to bone fractures or osteotomies are known to result in different healing outcomes. However, the local stimuli that promote formation of different skeletal tissues have yet to be established. Finite element analyses can estimate local stresses and strains but require many assumptions regarding tissue material properties and boundary conditions. This study used an experimental approach to investigate relationships between the strains experienced by tissues in a mechanically stimulated osteotomy gap and the patterns of tissue differentiation that occur during healing. Strains induced by the applied, global mechanical loads were quantified on the mid-sagittal plane of the callus using digital image correlation. Strain fields were then compared to the distribution of tissue phenotypes, as quantified by histomorphometry, using logistic regression. Significant and consistent associations were found between the strains experienced by a region of the callus and the tissue type present in that region. Specifically, the probability of encountering cartilage increased, and that of encountering woven bone decreased, with increasing octahedral shear strain and, to a lesser extent, maximum principal strain. Volumetric strain was the least consistent predictor of tissue type, although towards the end of the four-week stimulation timecourse, cartilage was associated with increasingly negative volumetric strains. These results indicate that shear strain may be an important regulator of tissue fate during skeletal healing.

Mechanical stimuli can trigger intracellular calcium (Ca2+) responses in osteocytes and osteoblasts. Successful construction of bone cell networks necessitates more elaborate and systematic analysis for the spatiotemporal properties of Ca2+ signaling in the networks. In the present study, an unsupervised algorithm based on independent component analysis (ICA) was employed to extract the Ca2+ signals of bone cells in the network. We demonstrated that the ICA-based technology could yield higher signal fidelity than the manual region of interest (ROI) method. Second, the spatiotemporal properties of Ca2+ signaling in osteocyte-like MLO-Y4 and osteoblast-like MC3T3-E1 cell networks under laminar and steady fluid flow stimulation were systematically analyzed and compared. MLO-Y4 cells exhibited much more active Ca2+ transients than MC3T3-E1 cells, evidenced by more Ca2+ peaks, less time to the 1st peak and less time between the 1st and 2nd peaks. With respect to temporal properties, MLO-Y4 cells demonstrated higher spike rate and Ca2+ oscillating frequency. The spatial intercellular synchronous activities of Ca2+ signaling in MLO-Y4 cell networks were higher than those in MC3T3-E1 cell networks and also negatively correlated with the intercellular distance, revealing faster Ca2+ wave propagation in MLO-Y4 cell networks. Our findings show that the unsupervised ICA-based technique results in more sensitive and quantitative signal extraction than traditional ROI analysis, with the potential to be widely employed in Ca2+ signaling extraction in the cell networks. The present study also revealed a dramatic spatiotemporal difference in Ca2+ signaling for osteocytic and osteoblastic cell networks in processing the mechanical stimulus. The higher intracellular Ca2+ oscillatory behaviors and intercellular coordination of MLO-Y4 cells provided further evidences that osteocytes may behave as the major mechanical sensor in bone modeling and remodeling processes.

Fracture-healing is regulated in part by mechanical factors. Study of the processes by which the mechanical environment of a fracture modulates healing can yield new strategies for the treatment of bone injuries. This article focuses on several key unanswered questions in the study of mechanotransduction and fracture repair. These questions concern identifying the mechanical stimuli that promote bone-healing, defining the mechanisms that are involved in this process, and examining the potential for cross-talk between investigations of mechanotransduction in bone-healing and in healing of other mesenchymally derived tissues. Several approaches to obtain accurate estimates of the mechanical stimuli present within a fracture callus are proposed, and our current understanding of the mechanotransduction processes involved in bone-healing is reviewed. Further study of mechanotransduction mechanisms is needed in order to identify those that are most critical and active during the various phases of fracture repair. A better understanding of the effect of mechanical factors on bone-healing will also benefit the study of healing, regeneration, and engineering of other skeletal tissues. The Mechanical Environment of a Healing FractureFracture-healing is governed by genetic as well as epigenetic factors. The mechanical environment of a healing fracture is one such epigenetic factor that is known to have a profound influence on the rate and success of the repair process. Understanding the effect of the mechanical environment, and in particular the mechanisms by which mechanical cues modulate bone-healing, has applications ranging from clinical management of fractures to bone-tissue engineering and basic science investigations of cell fate.Multiple parameters contribute to the mechanical environment of a fracture callus. These include the stability of fixation, the geometry or type of fracture, and the type of loading. For example, highly stable fixation, such as that provided by a rigidly applied internal fixation plate and by an interfragmentary screw, results in primary cortical healing without the formation of a callus. Less stable external fixation results in a cartilaginous callus, the size of which depends heavily on the stiffness of the fixator frame 1-3 . The geometry or type of fracture affects how the external loads are transferred to the callus tissue. A simple example is the comparison of a transverse fracture line to an oblique fracture line. Even under the same axial compressive Corresponding author: Elise F. Morgan, PhD, Department of Aerospace and Mechanical Engineering, Boston University, 110 Cummington Street, Boston, MA 02215. E-mail address: efmorgan@bu.edu. Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from the National Institutes of Health (grant #AR053353) and the Whitaker Foundation (graduate fellowship) and of less than $10,000 from Boston University (undergraduate ...

One of the earliest responses of bone cells to mechanical stimuli is a rise in intracellular calcium (Ca2+), and osteocytes in particular exhibit robust oscillations in Ca2+ when subjected to loading. Previous studies implicate roles for both the endoplasmic reticulum (ER) and T-Type voltage-sensitive calcium channels (VSCC) in these responses, but their interactions or relative contributions have not been studied. By observing Ca2+ dynamics in the cytosol (Ca2+cyt) and the ER (Ca2+ER), the focus of this study was to explore the role of the ER and T-Type channels in Ca2+ signaling in bone cells. We demonstrate that inhibition of T-Type VSCC in osteocytes significantly reduces the number of Ca2+cyt responses and affects Ca2+ER depletion dynamics. Simultaneous observation of Ca2+ exchange among these spaces revealed high synchrony between rises in Ca2+cyt and depressions in Ca2+ER, and this synchrony was significantly reduced by challenging T-Type VSCC. We further confirmed that this effect was mediated directly through the ER and not through store-operated Ca2+ entry (SOCE) pathways. Taken together, our data suggests that T-Type VSCC facilitate the recovery of Ca2+ER in osteocytes to sustain mechanically-induced Ca2+ oscillations, uncovering a new mechanism underlying the behavior of osteocytes as mechanosensors.

The mechanical properties of a healing bone fracture depend not only on the geometry of the fracture callus but also on the material properties of the callus tissues. Despite the biomechanical importance of callus tissues in restoring mechanical integrity to the injured bone, little is known about the material properties of these tissues and whether these properties can be estimated non-invasively. This study used nanoindentation to quantify the spatial variations in indentation modulus throughout the fracture callus and correlated the measurements of modulus with measurements of tissue mineral density (TMD) obtained from images from micro-computed tomography (µCT). Fracture calluses were harvested from rats 24 days following creation of a full-thickness, transverse osteotomy in the femoral mid-diaphysis. Calluses were imaged using µCT, and the average TMD and the median grayvalue (X-ray attenuation) of five, pre-defined volumes of interest (VOIs) in each callus were computed. Nanoindentation was then performed at multiple, regularly spaced locations across 150 µm-thick, sagittal sections of the calluses. The indentation modulus ranged from 0.51 to 1680 MPa throughout the callus, with the highest moduli in the center of the fracture gap and the lowest in the periphery of the gap (P < 0.05). TMD was also highest in the center of the gap (P < 0.05). An increasing trend in both modulus and TMD was observed in the regions of the callus adjacent to the periosteal surfaces of the cortex. While no correlation was found between the average indentation modulus in a given VOI and the median grayvalue of that VOI, the average indentation modulus and the average TMD were positively correlated (R = 0.70, P < 0.05). Together, these findings establish the spatial heterogeneity in the mechanical behavior of tissues in fracture calluses and indicate that the indentation modulus of these tissues can be estimated by non-invasive measurements of tissue mineralization.

The stiffness and strength of a healing bone fracture depend on the geometry of the fracture callus as well as the mechanical properties of the callus tissues. In the clinical setting, the mechanical stability of a healing fracture is often estimated qualitatively based on the radioopacity of the callus tissue. However, a quantitative association between tissue mineralization and mechanical properties has yet to be established for these tissues. Quantifying callus tissue material properties and mineral content may therefore enable improved non-invasive assessments of bone healing. In addition, elucidating relationships between callus tissue composition and function will provide a means of understanding the mechanism by which the injured bone recovers its mechanical integrity.