Search

Abstract: Quantitative ultrasound has been recognized as a useful tool for fracture risk prediction. Current measurement techniques are limited to peripheral skeletal sites. Our objective was to demonstrate the in vitro feasibility of ultrasonic velocity measurements on human proximal femur and to investigate the relationship between velocity and bone mineral density (BMD). Sound velocity images were computed from 2-D scans performed on 38 excised human femurs in transmission at 0.5 MHz. Different regions-of-interest were investigated. Dual x-ray absorptiometry scans have been achieved for BMD measurements in site-matched regions. Our study demonstrates the feasibility of ultrasonic velocity measurements at the hip with reasonable precision (coefficient of variation of 0.3%). The best prediction of BMD was reached in the intertrochanter region (r2 = 0.91, p < 10−4), with a residual error of 0.06 g/cm2 (10%). Because BMD measured at the femur is the best predictor of hip fracture risk, the highly significant correlation and small residual error found in this study suggest that speed of sound measurement at the femur might be a good candidate for hip fracture risk prediction. (E-mail: Frederic.padilla@lip.bhdc.jussieu.fr) [Copyright &y& Elsevier]

Abstract: The physical principles underlying quantitative ultrasound (QUS) measurements in trabecular bone are not fully understood. The translation of QUS results into bone strength remains elusive. However, ultrasound being mechanical waves, it is likely to assess apparent bone elasticity. The aim of this study is to derive the sensitivity of QUS parameters to variations of apparent bone elasticity, a surrogate for strength. The geometry of 34 human trabecular bone samples cut in the great trochanter was reconstructed using 3-D synchrotron micro-computed tomography. Finite-difference time-domain simulations coupled to 3-D micro-structural models were performed in the three perpendicular directions for each sample and each direction. A voxel-based micro-finite element linear analysis was employed to compute the apparent Young''s modulus (E) of each sample for each direction. For the antero-posterior direction, the predictive power of speed of sound and normalized broadband ultrasonic attenuation to assess E was equal to 0.9 and 0.87, respectively, which is better than what is obtained using bone density alone or coupled with micro-architectural parameters and of the same order of what can be achieved with the fabric tensor approach. When the direction of testing is parallel to the main trabecular orientation, the predictive power of QUS parameters decreases and the fabric tensor approach always gives the best results. This decrease can be explained by the presence of two longitudinal wave modes. Our results, which were obtained using two distinct simulation tools applied on the same set of samples, highlight the potential of QUS techniques to assess bone strength. [Copyright &y& Elsevier]

The evolution of the bone-implant interface reflects the implant osseointegration and bond strength, thereby determining the overall implant stability in the jawbone. Quantitative ultrasound represents a promising alternative technique to characterize the interfacial integrity, precisely due to the fact that those waves propagate essentially along the bone-implant interface, and are therefore influenced by its state. This study reports a numerical investigation of ultrasonic wave propagation for a commercial implant-jawbone system in which the thickness and mechanical properties of the interfacial layer (corresponding to the interphase) are systematically varied through the application of a rule of mixtures, in order to mimic the evolution from a dominantly soft tissue - like medium up to a fully healed bone. A simple figure of merit is devised in terms of an RMS-like (root mean square) factor based on the implant displacements, that evolves continuously and significantly with the bone "healing" process, thereby providing unequivocal information on the nature of the investigated bone-implant interface. The results show that the wave propagation pattern is primarily dictated by the impedance mismatch rather than by the interface thickness. This study validates the concept of quantitative ultrasonic testing as a sensitive alternative to the widespread resonant frequency analysis, thereby opening the way for future sensitivity analyses that will address more refined bone-implant interface pathologies such as those observed in the clinical realm. [ABSTRACT FROM AUTHOR]

Highlights • A finite element model of resonant frequency analysis of dental implants. • Peri-implant interface of varying stiffness and thickness to mimic bone remodeling. • Sensitivity analysis of the RFA. • Results show an increased sensitivity for wider and softer peri-implant layers. • Upon peri-implant bone stiffening, the sensitivity of RFA decreases rapidly. Abstract Dental implant stability influences the decision on the determination of the duration between implant insertion and loading. This work investigates the resonant frequency analysis by means of a numerical model. The investigation is done numerically through the determination of the eigenfrequencies and performing steady state response analyses using a commercial finite element package. A peri-implant interface, of simultaneously varying stiffness, density and layer thickness is introduced in the numerical 3D model in order to probe the sensitivity of the eigenfrequencies and steady state response to an evolving weakened layer, in an attempt to identify the bone reconstruction around the implant. For the first two modes, the resonant frequency is somewhat insensitive to the healing process, unless the weakened layer is rather large and compliant, like in the very early stages of the implantation. A "Normalized Healing Factor" is devised in the spirit of the Implant Stability Quotient, which can identify the healing process especially at the early stages after implantation. The sensitivity of the resonant frequency analysis to changes of mechanical properties of periprosthetic bone tissue seems relatively weak. Another indicator considering the amplitude as well as the resonance frequency might be more adapted to bone healing estimations. However, these results need to be verified experimentally as well as clinically. [ABSTRACT FROM AUTHOR]

Abstract: Osteoporotic hip fractures represent a major public health problem associated with high human and economic costs. The anatomical variation of the tissue mineral density (TMD) and of the elastic constants in femoral neck cortical bone specimens is an important determinant of bone fragility. The purpose of this study was to show that a Synchrotron radiation microcomputed tomography system coupled with a multiscale biomechanical model allows the determination of the 3-D anatomical dependence of TMD and of the elastic constants (i.e. the mechanical properties of an anisotropic material) in human femoral neck. Bone specimens from the inferior femoral neck were obtained from 18 patients undergoing standard hemiarthroplasty. The specimens were imaged using 3-D synchrotron micro-computed tomography with a voxel size of 10.13μm, leading to the determination of the anatomical distributions of porosity and TMD. The elastic properties of bone tissue were computed using a multiscale model. The model uses the experimental data obtained at the scale of several micrometers to estimate the components of the elastic tensor of bone at the scale of the organ. Statistical analysis (ANOVA) revealed a significant effect of the radial position on porosity and TMD and a significant effect of axial position on TMD only. Porosity was found to increase in the radial direction moving from the periosteum inwards (p<10−5). At any given distance from the periosteum, porosity does not vary noticeably along the bone axis. TMD was found to be significantly higher (p<10−5) in the periosteal region than in other bone locations and decreases from the periosteal to the endosteal region with an average slope of 10.05g.cm−3.m−1, the decrease being faster in the porous part of the samples (average slope equal of 30.04g.cm−3.m−1) than in dense cortical bone. TMD was found to decrease from the distal to the proximal part of the femur neck (average slope of 6.5g.cm−3.m−1). Considering TMD variations in the radial direction induces weak changes of bone properties compared to constant TMD. TMD variations in the axial direction are responsible for a significant variation of elastic constants. These results demonstrate that the anatomical variations of TMD affect the bone elastic properties, which could be explained by the complex stress field in bone affecting bone remodeling. TMD spatial variations should be taken into account to properly describe the spatial heterogeneity of elastic coefficients of bone tissue at the organ scale. [Copyright &y& Elsevier]

Abstract: Cortical bone is a multiscale composite material. Its elastic properties are anisotropic and heterogeneous across its cross-section, due to endosteal bone resorption which might affect bone strength. The aim of this paper was to describe a homogenization method leading to the estimation of the variation of the elastic coefficients across the bone cross-section and along the bone longitudinal axis. The method uses the spatial variations of bone porosity and of the degree of mineralization of the bone matrix (DMB) obtained from the analysis of 3-D synchrotron micro-computed tomography images. For all three scales considered (the foam (100nm), the ultrastructure (5μm) and the mesoscale (500μm)), the elastic coefficients were determined using the Eshelby’s inclusion problem. DMB values were used at the scale of the foam. Collagen was introduced at the scale of the ultrastructure and bone porosity was introduced at the mesoscale. The pores were considered as parallel cylinders oriented along the bone axis. Each elastic coefficient was computed for different regions of interest, allowing an estimation of its variations across the bone cross-section and along the bone longitudinal axis. The method was applied to a human femoral neck bone specimen, which is a site of osteoporotic fracture. The computed elastic coefficients for cortical bone were in good agreement with experimental results, but some discrepancies were obtained in the endosteal part (trabecular bone). These results highlight the importance of accounting for the heterogeneity of cortical bone properties across bone cross-section and along bone longitudinal axis. [Copyright &y& Elsevier]