Composites made of rapidly resorbable ceramics and poly(lactide) show adequate mechanical properties for use as bone substitute materials.

Porous composite materials made of poly(L, DL-lactide) and a ceramic component, alpha-tricalcium phosphate (alpha-TCP) or one of the rapidly resorbable glass ceramics, GB9N or GB14N, respectively, were developed to be used as bone substitutes. The present article describes the mechanical properties and the in vitro degradation characteristic of the different composite materials. The yield strength, the elastic modulus, and the molecular weight were measured after in vitro degradation up to 78 weeks.

Degradation behavior of composite pins made of tricalcium phosphate and poly(L,DL-lactide).

Combining a bioactive ceramic with a resorbable polymer may improve the biocompatibility and the osseointegration of degradable fracture fixation devices. This study reports on the mechanical properties and degradation behavior of two composite pins made of poly(L,DL-lactide) and 10 and 30% beta-tricalcium phosphate (TCP), respectively. The pins were compared to a pin made of 100% poly(L,DL-lactide).

A new bioresorbable polymer for screw augmentation in the osteosynthesis of osteoporotic cancellous bone: a biomechanical evaluation.

The aim of the study was to assess the mechanical efficacy of a new resorbable polymer developed on the basis of alkylene bis(dilactoyl)-methacrylate to improve the anchorage of osteosynthesis material in cancellous bone. Cancellous bone screws were inserted in bovine as well as in human vertebrae and human femoral condyles and were augmented with the new polymer or polymethylmethacrylate (PMMA), respectively. Nonaugmented screws were used as controls.

Effects of high-frequency, low-magnitude mechanical stimulus on bone healing.

Recent studies have shown osteogenic effects of high-frequency mechanical stimuli. The purpose of this study was whether externally applied, high-frequency, low-magnitude interfragmentary movements affect the process of bone healing. In 12 sheep, a transverse osteotomy with a 3 mm gap was created in the right metatarsus and externally stabilized by a rigid circular fixator.

Predictive value of Singh index and bone mineral density measured by quantitative computed tomography in determining the local cancellous bone quality of the proximal femur.

Objective: The purpose of this study was to assess the predictive value of the Singh index as well as quantitative computed tomography for the in vitro local mechanical competence of the cancellous bone of the proximal femur.

Design: An experimental study examining the relation between mechanical properties and bone mineral density of the femoral neck determined in vitro and the clinical estimated Singh index on X-rays.

Background: Evaluation of the predictive value of the Singh index, an inexpensive and simple technique for the mechanical properties of the cancellous bone of the proximal femur.

Prediction of strength of cortical bone in vitro by microcomputed tomography.

Objective: The aim of this study was to evaluate the predictive value of bone mineral density and intracortical porosity measured by microcomputed tomography for the strength of cortical bone biopsies.

Design: Experimental study comparing the predictive value of bone mineral density and of intracortical porosity determined in vitro by microcomputed tomography for the mechanical properties of cortical bone cylinders.

Background: The assessment of cortical bone strength might be relevant for the prediction of fracture risk or the choice of suitable therapy strategies in orthopaedic surgery.

Predictive value of bone mineral density and morphology determined by peripheral quantitative computed tomography for cancellous bone strength of the proximal femur.

Peripheral quantitative computed tomography (pQCT) is an established diagnostic method for assessment of bone mineral density in the diagnosis of osteoporosis. However, the capacity of structural parameters of cancellous bone measured by high-resolution computed tomography remains to be explored. In 33 patients, bone mineral density (BMD) of the proximal femur was measured in vitro by pQCT using cylindrical biopsies from the intertrochanteric region harvested before the implantation of an artificial hip joint.

Mechanical stimulation by external application of cyclic tensile strains does not effectively enhance bone healing.

Objective: To determine whether an externally induced interfragmentary movement enhances the healing process of a fracture under flexible fixation.

Design: Randomized, prospective in vivo animal study with control group. Twenty-four skeletally mature Merino sheep were randomly assigned to six groups of four animals, which received cyclic interfragmentary movements of 0.

Prediction of cortical bone porosityIn Vitro by microcomputed tomography.

The high importance of intracortical porosity for mechanical strength of cortical bone has been established. The contribution of other parameters of microstructure such as osteon dimensions for strength is in discussion. The aim of this study was to evaluate the predictive value of microcomputed tomography (µCT) for porosity and other microstructural parameters of cortical bone in cortical bone biopsies.

In vivo assessment of trabecular bone structure using fractal analysis of distal radius radiographs.

Our purpose in this study was (i) to measure trabecular bone structure using fractal analysis of distal radius radiographs in subjects with and without osteoporotic hip fractures, and (ii) to compare these measures with bone mineral density (BMD) as well as with measures of trabecular bone structure derived from high resolution magnetic resonance (MR) images. Distal radius radiographs were obtained using semi-industrial films (55 kVp, 400 mAs) in 30 postmenopausal patients, who had suffered osteoporotic hip fractures (74.8+/-8.

[Mechanical modification of callus healing].

Interfragmentary movement and size of the fracture gap influence fracture healing. Limited movements promote callus formation and may result in increased mechanical stability. Although larger movements still promote callus formation, the bony consolidation of the fracture is hampered.

Prediction of bone strength of distal forearm using radius bone mineral density and phalangeal speed of sound.

This investigation compares quantitative ultrasound (QUS) measurement of the phalanges with peripheral quantitative computed tomography (pQCT) and dual X-ray absorptiometry (DXA) measurement of the forearm, to estimate the strength of the distal radius in 13 cadaveric forearms. The cadavers were scanned at the distal radius by pQCT and DXA for bone mineral density (BMD) and at the approximate phalanges by QUS for speed of sound (SOS). The distal radii were subjected to a simulated Colles fracture produced with a materials testing machine.

Trabecular bone architecture in the distal radius using magnetic resonance imaging in subjects with fractures of the proximal femur. Magnetic Resonance Science Center and Osteoporosis and Arthritis Research Group.

To determine whether magnetic resonance (MR)-derived measures of trabecular bone architecture in the distal radius are predictive for prevalent hip fractures, 20 subjects with hip fractures and 19 age-matched postmenopausal controls were studied. Bone mineral density (BMD) measures at the hip (dual-energy X-ray absorptiometry, DXA) and the distal radius (peripheral quantitative computed tomography, pQCT) were also obtained. We compared the MR-based structural measures derived in the radius with those in the calcaneus of the same patients.

Predictive value of bone mineral density and Singh index for the in vitro mechanical properties of cancellous bone in the femoral head.

Objective: The purpose of this study was to assess the validity of two methodically different radiological parameters, bone mineral density and Singh Index, for the prediction of mechanical properties in femoral cancellous bone.

Design: Coherence between in vitro evaluation of mechanical properties and bone mineral density on a femoral bone slice, combined with clinical determination of Singh Index on ordinary X-rays.

Background: It is accepted that bone densitometry yields excellent prediction of mechanical bone quality, but is considered to be an expensive and not widely available method for routine diagnostics in clinical practice.

Fractal analysis of radiographs: assessment of trabecular bone structure and prediction of elastic modulus and strength.

The purpose of this study was to determine whether fractal dimension of radiographs provide measures of trabecular bone structure which correlate with bone mineral density (BMD) and bone biomechanics, and whether these relationships depend on the technique used to calculate the fractal dimension. Eighty seven cubic specimen of human trabecular bone were obtained from the vertebrae and femur. The cubes were radiographed along all three orientations--superior-inferior (SI), medial-lateral (ML), and anterior-posterior (AP), digitized, corrected for background variations, and fractal based techniques were applied to quantify trabecular structure.

Image-based assessment of spinal trabecular bone structure from high-resolution CT images.

The goal of this study was to assess whether a high-resolution CT measure of trabecular bone structure can enhance the discrimination between subjects with or without a vertebral fracture and having overall low hip or spine bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA). Sixty-one women with low BMD by DXA (T-score < -2.5 at hip or spine) were examined.

Quantitative bone mineral assessment at the forearm: a review.

Bone mineral density and geometric properties of the human forearm can be measured to determine the amount of bone or bone loss at the scanning site and to predict the risk of forearm fractures. These forearm measurements are also used to estimate bone mass at remote anatomical locations and thereby estimate the risk for spine, hip and other fractures. The peripheral location of the human forearm, with its relatively small amount of surrounding soft tissue, improves the accuracy and the precision of bone mass measurement and has made this site an early choice for the assessment of a subject's bone mineral status.

Effects of mechanical factors on the fracture healing process.

An interdisciplinary study based on animal experiments, cell culture studies, and finite element models is presented. In a sheep model, the influence of the osteotomy gap size and interfragmentary motion on the healing success was investigated. Increasing gap sizes delayed the healing process.

Ultrasound velocity of trabecular cubes reflects mainly bone density and elasticity.

Studies have indicated that quantitative ultrasound (QUS) variables may be influenced by the mechanical properties of bone which in turn are determined by bone's material and structural properties. However, from these studies it is unclear what role density, elasticity, and structure play in determining velocity. Eighteen defatted, 12-mm cubic trabecular bone specimens were cut from cadaveric specimens.

Distal radius fractures: mechanisms of injury and strength prediction by bone mineral assessment.

The strength of the radius depends on the mechanical properties of cancellous and cortical bone. By assessing both compartments quantitatively with bone densitometry, we tried to identify the specificity of each in predicting the load at which the distal radius will fracture. Twenty human cadaver forearms were scanned for bone mineral and geometric properties with quantitative computed tomography and dual x-ray absorptiometry.

Power spectral analysis of vertebral trabecular bone structure from radiographs: orientation dependence and correlation with bone mineral density and mechanical properties.

Trabecular bone structure and bone density contribute to the strength of bone and are potentially important in the study of osteoporosis. Fourier transforms of the textural patterns in radiographs of trabecular bone have previously been used for the measurement of trabecular bone structure in subjects, however, the relationship between these measures and biomechanical properties of bone have not previously been established. In this study radiographs were acquired of 28 cubic specimens of spinal trabecular bone along each of the three anatomic axes: cranio-caudal or superior-inferior (SI), medial-lateral (ML), and anterior-posterior (AP).

Accuracy of cortical and trabecular bone measurements with peripheral quantitative computed tomography (pQCT).

In order to assess the accuracy of peripheral QCT (Stratec XCT 960) we analysed scans of the European Forearm Phantom and another phantom consisting of K2HPO4 encased in aluminium tubes to simulate cortical walls. Additionally 14 cadaveric forearm specimen scans were compared to CT scans acquired on a GE9800Q. The accuracy for density assessment of the European Forearm Phantom was better than 3%.

Proximal femur: assessment for osteoporosis with T2* decay characteristics at MR imaging.

Purpose: To use T2* measurements at magnetic resonance (MR) imaging to investigate the trabecular structure of the hip in women with and women without osteoporotic hip fractures and to compare this technique with bone mineral density (BMD) measurements in the diagnosis of fractures.

Materials And Methods: T2* maps of the proximal femur were obtained at 1.5 T in 23 postmenopausal study patients with osteoporotic hip fractures, 27 age-matched healthy postmenopausal control subjects, and five healthy premenopausal control subjects.

Trochanteric hip fracture: strong association with spinal trabecular bone mineral density measured with quantitative CT.

Purpose: To determine the discriminatory capability for hip fracture of trabecular and integral bone mineral density (BMD) measured with quantitative computed tomography (CT) of the spine.

Materials And Methods: Fifty-six women who had sustained hip fractures and 59 control subjects underwent volumetric quantitative CT of L1 and L2 and dual x-ray absorptiometry of the hip. BMD was measured in vertebral regions of interest that encompassed trabecular, cortical, and integral bone.