The micro-architecture of human cancellous bone from fracture neck of femur patients in relation to the structural integrity and fracture toughness of the tissue
Osteoporosis is clinically assessed from bone mineral density measurements using dual energy X-ray absorption (DXA). However, these measurements do not always provide an accurate fracture prediction, arguably because DXA does not grapple with ‘bone quality’, which is a combined result of microarchit...
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| Format: | Article |
| Language: | English |
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Elsevier
2015-12-01
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| Series: | Bone Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352187215300176 |
| _version_ | 1818602574357463040 |
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| author | C. Greenwood J.G. Clement A.J. Dicken J.P.O. Evans I.D. Lyburn R.M. Martin K.D. Rogers N. Stone G. Adams P. Zioupos |
| author_facet | C. Greenwood J.G. Clement A.J. Dicken J.P.O. Evans I.D. Lyburn R.M. Martin K.D. Rogers N. Stone G. Adams P. Zioupos |
| author_sort | C. Greenwood |
| collection | DOAJ |
| description | Osteoporosis is clinically assessed from bone mineral density measurements using dual energy X-ray absorption (DXA). However, these measurements do not always provide an accurate fracture prediction, arguably because DXA does not grapple with ‘bone quality’, which is a combined result of microarchitecture, texture, bone tissue properties, past loading history, material chemistry and bone physiology in reaction to disease. Studies addressing bone quality are comparatively few if one considers the potential importance of this factor. They suffer due to low number of human osteoporotic specimens, use of animal proxies and/or the lack of differentiation between confounding parameters such as gender and state of diseased bone. The present study considers bone samples donated from patients (n = 37) who suffered a femoral neck fracture and in this very well defined cohort we have produced in previous work fracture toughness measurements (FT) which quantify its ability to resist crack growth which reflects directly the structural integrity of the cancellous bone tissue. We investigated correlations between BV/TV and other microarchitectural parameters; we examined effects that may suggest differences in bone remodelling between males and females and compared the relationships with the FT properties. The data crucially has shown that TbTh, TbSp, SMI and TbN may provide a proxy or surrogate for BV/TV. Correlations between FT critical stress intensity values and microarchitecture parameters (BV/TV, BS/TV, TbN, BS/BV and SMI) for osteoporotic cancellous tissue were observed and are for the first time reported in this study. Overall, this study has not only highlighted that the fracture model based upon BMD could potentially be improved with inclusion of other microarchitecture parameters, but has also given us clear clues as to which of them are more influential in this role. |
| first_indexed | 2024-12-16T13:09:26Z |
| format | Article |
| id | doaj.art-a0b588464e0044df907ae0dacc7ca190 |
| institution | Directory Open Access Journal |
| issn | 2352-1872 |
| language | English |
| last_indexed | 2024-12-16T13:09:26Z |
| publishDate | 2015-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Bone Reports |
| spelling | doaj.art-a0b588464e0044df907ae0dacc7ca1902022-12-21T22:30:40ZengElsevierBone Reports2352-18722015-12-013C677510.1016/j.bonr.2015.10.001The micro-architecture of human cancellous bone from fracture neck of femur patients in relation to the structural integrity and fracture toughness of the tissueC. Greenwood0J.G. Clement1A.J. Dicken2J.P.O. Evans3I.D. Lyburn4R.M. Martin5K.D. Rogers6N. Stone7G. Adams8P. Zioupos9Cranfield Forensic Institute, Cranfield University, Defence Academy of the UK, Shrivenham, UKForensic Odontology, Melbourne Dental School, University of Melbourne, Melbourne, AustraliaThe Imaging Science Group, Nottingham Trent University, Nottingham, UKThe Imaging Science Group, Nottingham Trent University, Nottingham, UKCobalt Health, Cheltenham, UKSocial and Community Medicine, Bristol University, Bristol, UKCranfield Forensic Institute, Cranfield University, Defence Academy of the UK, Shrivenham, UKPhysics and Astronomy, Exeter University, Exeter, UKCranfield Forensic Institute, Cranfield University, Defence Academy of the UK, Shrivenham, UKCranfield Forensic Institute, Cranfield University, Defence Academy of the UK, Shrivenham, UKOsteoporosis is clinically assessed from bone mineral density measurements using dual energy X-ray absorption (DXA). However, these measurements do not always provide an accurate fracture prediction, arguably because DXA does not grapple with ‘bone quality’, which is a combined result of microarchitecture, texture, bone tissue properties, past loading history, material chemistry and bone physiology in reaction to disease. Studies addressing bone quality are comparatively few if one considers the potential importance of this factor. They suffer due to low number of human osteoporotic specimens, use of animal proxies and/or the lack of differentiation between confounding parameters such as gender and state of diseased bone. The present study considers bone samples donated from patients (n = 37) who suffered a femoral neck fracture and in this very well defined cohort we have produced in previous work fracture toughness measurements (FT) which quantify its ability to resist crack growth which reflects directly the structural integrity of the cancellous bone tissue. We investigated correlations between BV/TV and other microarchitectural parameters; we examined effects that may suggest differences in bone remodelling between males and females and compared the relationships with the FT properties. The data crucially has shown that TbTh, TbSp, SMI and TbN may provide a proxy or surrogate for BV/TV. Correlations between FT critical stress intensity values and microarchitecture parameters (BV/TV, BS/TV, TbN, BS/BV and SMI) for osteoporotic cancellous tissue were observed and are for the first time reported in this study. Overall, this study has not only highlighted that the fracture model based upon BMD could potentially be improved with inclusion of other microarchitecture parameters, but has also given us clear clues as to which of them are more influential in this role.http://www.sciencedirect.com/science/article/pii/S2352187215300176OsteoporosisMicroarchitectureFracture toughness (FT)Computed tomography (CT)Bone mineral density (BMD) |
| spellingShingle | C. Greenwood J.G. Clement A.J. Dicken J.P.O. Evans I.D. Lyburn R.M. Martin K.D. Rogers N. Stone G. Adams P. Zioupos The micro-architecture of human cancellous bone from fracture neck of femur patients in relation to the structural integrity and fracture toughness of the tissue Bone Reports Osteoporosis Microarchitecture Fracture toughness (FT) Computed tomography (CT) Bone mineral density (BMD) |
| title | The micro-architecture of human cancellous bone from fracture neck of femur patients in relation to the structural integrity and fracture toughness of the tissue |
| title_full | The micro-architecture of human cancellous bone from fracture neck of femur patients in relation to the structural integrity and fracture toughness of the tissue |
| title_fullStr | The micro-architecture of human cancellous bone from fracture neck of femur patients in relation to the structural integrity and fracture toughness of the tissue |
| title_full_unstemmed | The micro-architecture of human cancellous bone from fracture neck of femur patients in relation to the structural integrity and fracture toughness of the tissue |
| title_short | The micro-architecture of human cancellous bone from fracture neck of femur patients in relation to the structural integrity and fracture toughness of the tissue |
| title_sort | micro architecture of human cancellous bone from fracture neck of femur patients in relation to the structural integrity and fracture toughness of the tissue |
| topic | Osteoporosis Microarchitecture Fracture toughness (FT) Computed tomography (CT) Bone mineral density (BMD) |
| url | http://www.sciencedirect.com/science/article/pii/S2352187215300176 |
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