Age-and region-dependent changes in three-dimensional microstructural properties of proximal femoral trabeculae

Cui, Wen; Won, Ye Yeon; Baek, Myong Hyun; Lee, D.-H.; Chung, Yoon‐Sok; Hur, Jinyoung; Ma, Yuanfang

doi:10.1007/s00198-008-0601-7

Cited by 47 publications

(46 citation statements)

References 30 publications

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“…Therefore it is more brittle and more likely to fracture. Conn.D decreases significantly with age [49,50] . When the trabecular bone volume fraction declines, Conn.D will decline concomitantly, probably because of small trabecular bone loss [25,49] .…”

Section: Femoral Neckmentioning

confidence: 93%

“…There have been many studies conducted to investigate the underlying causes of femoral neck fracture. It is suggested that 3D microstructures play a significant role in assessing the bone quality and provide compelling evidence to explain the bone strength [48][49][50] . The proximal femur was isolated by cutting at the base of femoral head and femoral neck.…”

Section: Femoral Neckmentioning

confidence: 99%

“…Tb.N and Tb.Th decline, while Tb.Sp increases in males and females. The decrease of BV/TV with age is related to decreases in Tb.N and Tb.Th, and increases in Tb.Sp [49,50] . There are a few studies regarding SMI of femoral neck trabeculae [49,50,53] .…”

Section: Femoral Neckmentioning

confidence: 99%

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Bone three-dimensional microstructural features of the common osteoporotic fracture sites

Chen

Kubo

2014

WJO

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Osteoporosis is a common metabolic skeletal disorder characterized by decreased bone mass and deteriorated bone structure, leading to increased susceptibility to fractures. With aging population, osteoporotic fractures are of global health and socioeconomic importance. The three-dimensional microstructural information of the common osteoporosis-related fracture sites, including vertebra, femoral neck and distal radius, is a key for fully understanding osteoporosis pathogenesis and predicting the fracture risk. Low vertebral bone mineral density (BMD) is correlated with increased fracture of the spine. Vertebral BMD decreases from cervical to lumbar spine, with the lowest BMD at the third lumbar vertebra. Trabecular bone mass of the vertebrae is much lower than that of the peripheral bone. Cancellous bone of the vertebral body has a complex heterogeneous three-dimensional microstructure, with lower bone volume in the central and anterior superior regions. Trabecular bone quality is a key element to maintain the vertebral strength. The increased fragility of osteoporotic femoral neck is attributed to low cancellous bone volume and high compact porosity. Compared with age-matched controls, increased cortical porosity is observed at the femoral neck in osteoporotic fracture patients. Distal radius demonstrates spatial inhomogeneous characteristic in cortical microstructure. The medial region of the distal radius displays the highest cortical porosity compared with the lateral, anterior and posterior regions. Bone strength of the distal radius is mainly determined by cortical porosity, which deteriorates with advancing age. Key words: Osteoporosis; Fracture; Microstructure; Trabecular bone; Cortical bone; Vertebra; Femoral neck; Distal radius Core tip: The most common sites of the osteoporotic fractures include the vertebra, femoral neck and distal radius, where the microstructural information is a key for fully understanding osteoporosis pathogenesis and improving the prediction of fracture risk. Vertebral strength is mostly preserved by trabecular bone, which is microstructurally inhomogeneous, with lower bone volume in the central and anterior superior regions. Increased fragility of osteoporotic femoral neck is attributed to low cancellous bone volume and high compact porosity. Distal radius shows significant variations in cortical porosity, which is the major element attributed to bone strength of the distal radius.

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Section: Femoral Neckmentioning

confidence: 93%

Section: Femoral Neckmentioning

confidence: 99%

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Bone three-dimensional microstructural features of the common osteoporotic fracture sites

Chen

Kubo

2014

WJO

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“…A more recent study examined the microstructural differences in femoral neck trabecular bone between hip fracture patients and controls, and confirmed significant decrease in bone volume fraction and a transition from plate-like to rod-like trabeculae in hip fracture patients (12). However, microstructural and biomechanical changes associated with intertrochanteric fractures have not been studied, and cannot be derived from the previous femoral neck studies due to heterogeneous trabecular bone distribution in the proximal femur (13)(14). Also, Li et al suggested that location of hip fracture was most strongly associated with the vBMD near the site of fractures in femoral neck and intertrochanteric region (15).…”

Section: Introductionmentioning

confidence: 98%

Trabecular Plate Loss and Deteriorating Elastic Modulus of Femoral Trabecular Bone in Intertrochanteric Hip Fractures

et al. 2013

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Osteoporotic hip fracture is associated with significant trabecular bone loss, which is typically characterized as low bone density by dual-energy X-ray absorptiometry (DXA) and altered microstructure by micro-computed tomography (µCT). Emerging morphological analysis techniques, e.g. individual trabecula segmentation (ITS), can provide additional insights into changes in plate-like and rod-like trabeculae, two major microstructural types serving different roles in determining bone strength. Using ITS, we evaluated trabecular microstructure of intertrochanteric bone cores obtained from 23 patients undergoing hip replacement surgery for intertrochanteric fracture and 22 cadaveric controls. Micro-finite element (µFE) analyses were performed to further understand how the abnormalities seen by ITS might translate into effects on bone strength. ITS analyses revealed that, near fracture site, plate-like trabeculae were seriously depleted in fracture patients, but trabecular rod volume was maintained. Besides, decreased plate area and rod length were observed in fracture patients. Fracture patients also showed decreased elastic moduli and shear moduli of trabecular bone. These results provided evidence that in intertrochanteric hip fracture, preferential loss of plate-like trabeculae led to more rod-like microstructure and deteriorated mechanical competence adjacent to the fracture site, which increased our understanding of the biomechanical pathogenesis of hip fracture in osteoporosis.

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“…The weak correlation with age may indicate that an alteration of macroscopic mechanical competence of the proximal femur is associated with bone fragility (McCalden et al, 1993;Homminga et al, 2002) and is due to structural changes such as an decline in trabecular thickness and number (Cui et al, 2008;Djurić et al, 2012) and is not accompanied by the decreasing mechanical properties of trabecular bone at the microlevel. Nevertheless, it has been reported that the mechanical properties of bone tissue as measured by nanoindentation correlate to bone tissue age, which is associated with the degree of mineralization and bone remodelling.…”

mentioning

confidence: 99%

A study of human and bovine trabecular bones using nanoindentation and quantitative backscattered electron imaging

Lin¹

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Osteoporosis is a disease with which bone progressively loses density and becomes fragile, leading to high risk of bone fracture. It is a major health issue in Australia, especially in the elderly population. Early awareness about the disease can help find effective medication and reduce bone fractures with appropriate lifestyle changes. In medical diagnosis, bone mineral density (BMD) measurement is used. However, thereare increased evidences to demonstrate that BMD measurement alone may be insufficient to detect the pathological changes in bone that caused by the disease. Therefore, it is essential to gain a more complete understanding of the bone properties and their effect on osteoporosis.Bone is a hierarchical composite material, which mainly consists of mineral apatite and organic matrix. Previous studies found that osteoporosis or aging could cause microstructural changes in trabecular bones of a proximal femur, the most common site for osteoporosis, and an increased degree of anisotropy was observed in osteoporotic bone properties. To identify the risk of fracture occurrence in the proximal femur as well as to prevent bone fracture, it is important to understand the relationship between bone mineral composition and bone mechanical properties. This thesis thus focused on the characterisation of the mechanical properties and mineral composition of trabecular bone, in order to address several key issues relating to the causes of osteoporosis, including: how does trabecular bone respond to different loading directions? how do bone cysts (which are the implication of pathological scenario due to the trabecular fracture) affect the mechanical properties and the mineral composition of trabeculae ? how does the mineral content affect the mechanical properties of trabeculae across different trabecular types and pathology scenarios ?To answer those questions, trabecular bone samples harvested from bovine and human femoral heads were prepared for testing. Nanoindentation was first used to characterise the mechanical behaviour of trabeculae and atomic force microscopy (AFM) was employed to examine the bone surface tomography. Quantitative backscattered electron imaging (qBEI) was utilized for determining the bone mineral density distribution and the mineral content.ii The results showed that at microscopic scale longitudinal trabeculae were stiffer and harder than transverse trabeculae, because those bones were more highly mineralized.Longitudinal trabeculae also exhibited greater resistance to plastic deformation. The difference in mechanical properties between longitudinal and transverse trabeculae is partially attributed to the difference in their mineral compositions. To further understand the mechanical behaviour of trabeculae, longitudinal and transverse trabeculae were tested in two orthogonal directions. Results showed that both longitudinal and transverse trabeculae had greater elastic modulus in axial direction than in radial direction. Because the axial loading direction is axially aligned with th...

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Age-and region-dependent changes in three-dimensional microstructural properties of proximal femoral trabeculae

Abstract: Age-related changes in bone loss and trabecular microstructure within the male proximal femur are not uniform in this cadaveric population.

Cited by 47 publications

References 30 publications

Bone three-dimensional microstructural features of the common osteoporotic fracture sites

Bone three-dimensional microstructural features of the common osteoporotic fracture sites

Trabecular Plate Loss and Deteriorating Elastic Modulus of Femoral Trabecular Bone in Intertrochanteric Hip Fractures

A study of human and bovine trabecular bones using nanoindentation and quantitative backscattered electron imaging

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