Biomechanics of osteoporotic fractures

Springer Science and Business Media LLC - Tập 4 - Trang 143-153 - 2006
Mary L. Bouxsein1,2
1Department of Orthopedic Surgery, Harvard Medical School, Boston
2Orthopedic Biomechanics Laboratory, RN115, Beth Israel Deaconess Medical Center, Boston

Tóm tắt

There is increasing evidence that fracture risk in osteoporosis is not only related to bone mineral density but also to a compilation of factors that are often referred to under the legendary terminology “bone quality”. This article reviews initially the biomechanical aspects of trauma and then the current understanding of the many characteristics of bone that give it strength to resist trauma, including those characteristics that can currently be measured in vivo, those that will shortly be assessable, and those that yet defy measurement in the intact human. The mechanism by which antiresorptive and anabolic therapies for osteoporosis may affect bone strength are also discussed.

Tài liệu tham khảo

US Department of Health and Human Services. 2004 Bone Health and Osteoporosis: A Report of the Surgeon General. U.S. Department of Health and Human Services, Office of the Surgeon General, Rockville, MD. Anonymous. 2001 Osteoporosis prevention, diagnosis, and therapy. JAMA 285:785–795. Bouxsein M. 2001 Biomechanics of age-related fractures, In: Marcus R, Feldman D, Kelsey J (eds) Osteoporosis, 2nd ed. Academic, San Diego, pp. 509–534. Lotz J, Cheal E, Hayes W. 1995 Stress distributions within the proximal femur during gait and falls: implications for osteoporotic fracture. Osteoporos Int 5:252–261. Lochmuller EM, Groll O, Kuhn V, Eckstein F. 2002 Mechanical strength of the proximal femur as predicted from geometric and densitometric bone properties at the lower limb versus the distal radius. Bone 30:207–216. Keyak JH, Rossi SA, Jones KA, Skinner HB. 1998 Prediction of femoral fracture load using automated finite element modeling. J Biomech 31:125–133. Nevitt MC, Cummings SR. 1993 Type of fall and risk of hip and wrist fractures: the study of osteoporotic fractures. J Am Geriatr Soc 41:1226–1234. Greenspan SL, Myers ER, Maitland LA, Resnick NM, Hayes WC. 1994 Fall severity and bone mineral density as risk factors for hip fracture in ambulatory elderly. JAMA 271:128–133. Jones HH, Priest JD, Hayes WC, Tichenor CC, Nagel DA. 1977 Humeral hypertrophy in response to exercise. J Bone Jt Surg 59-A:204–208. Bonadio J, Jepsen KJ, Mansoura MK, Jaenisch R, Kuhn JL, Goldstein SA. 1993 A murine skeletal adaptation that significantly increases cortical bone mechanical properties. Implications for human skeletal fragility. J Clin Invest 92:1697–1705. Bouxsein ML. 2003 Bone quality: where do we go from here? Osteoporos Int 14(Suppl 5):118–127. Carter DR, Hayes WC. 1976 Bone compressive strength: the influence of density and strain rate. Science 194:1174–1176. Carter DR, Hayes WC. 1977 The compressive behavior of bone as a two-phase porous structure. J Bone Jt Surg 59-A:954–962. Rice JC, Cowin SC, Bowman JA. 1988 On the dependence of the elasticity and strength of cancellous bone on apparent density. J Biomech 21:155–168. Keaveny TM, Morgan EF, Niebur GL, Yeh OC. 2001 Biomechanics of trabecular bone. Annu Rev Biomed Eng 3:307–333. Currey J. 1986 Effects of porosity and mineral content on the Young's modulus of bone. Eur Soc Biomech 5:104. Currey J. 1990 Physical characteristics affecting the tensile failure properties of compact bone. J Biomech 23:837–844. Schaffler M, Burr D. 1988 Stiffness of compact bone: effects of porosity and density. J Biomech 21:13–16. McCalden R, McGeough J, Barker M, Court-Brown C. 1993 Age-related changes in the tensile properties of cortical bone. J Bone Jt Surg 75-A:1193–1205. Burr DB, Schaffler MB, Frederickson RG. 1988 Composition of the cement line and its possible mechanical role as a local interface in human compact bone. J Biomech 21:939–945. Burr DB, Forwood MR, Fyhrie DP, Martin RB, Schaffler MB, Turner CH. 1997 Bone microdamage and skeletal fragility in osteoporotic and stress fractures. J Bone Miner Res 12:6–15. Hoshaw S, Cody D, Saad A, Fhyrie D. 1997 Decrease in canine proximal femoral ultimate strength and stiffness due to fatigue damage. J Biomech 30:323–329. Schaffler M, Choi K, Milgrom C. 1995 Aging and matrix microdamage accumulation in human compact bone. Bone 17:521–525. Burr D. 2003 Microdamage and bone strength. Osteoporos Int 14(Suppl 5):S67-S72. Burr DB. 2002 The contribution of the organic matrix to bone's material properties. Bone 31:8–11. Turner CH, Burr DB. 1993 Basic biomechanical measurements of bone: a tutorial. Bone 14:595–608. van der Meulen MC, Jepsen KJ, Mikic B. 2001 Understanding bone strength: size isn't everything. Bone 29:101–104. Bouxsein ML, Coan BS, Lee SC. 1999 Prediction of the strength of the elderly proximal femur by bone mineral density and quantitative ultrasound measurements of the heel and tibia. Bone 25:49–54. Lochmuller EM, Burklein D, Kuhn V, et al. 2002 Mechanical strength of the thoracolumbar spine in the elderly: prediction from in situ dual-energy X-ray absorptiometry, quantitative computed tomography (QCT), upper and lower limb peripheral QCT, and quantitative ultrasound. Bone 31:77–84. Lochmuller EM, Lill CA, Kuhn V, Schneider E, Eckstein F. 2002 Radius bone strength in bending, compression, and falling and its correlation with clinical densitometry at multiple sites. J Bone Miner Res 17:1629–1638. Muller ME, Webber CE, Bouxsein ML. 2003 Predicting the failure load of the distal radius. Osteoporos Int 14: 345–352. Skaggs DL, Loro ML, Pitukcheewanont P, Tolo V, Gilsanz V. 2001 Increased body weight and decreased radial cross-sectional dimensions in girls with forearm fractures. J Bone Miner Res 16:1337–1342. Ahlborg HG, Johnell O, Turner CH, Rannevik G, Karlsson MK. 2003 Bone loss and bone size after menopause. N Engl J Med 349:327–334. Gilsanz V, Boechat MI, Gilsanz R, Loro ML, Roe TF, Goodman, WG. 1994 Gender differences in vertebral sizes in adults: biomechanical implications. Radiology 190: 678–682. Gilsanz V, Loro ML, Roe TF, Sayre J, Gilsanz R, Schulz EE. 1995 Vertebral size in elderly women with osteoporosis. Mechanical implications and relationship to fractures. J Clin Invest 95:2332–2337. Duan Y, Seeman E, Turner CH. 2001. The biomechanical basis of vertebral body fragility in men and women. J Bone Miner Res 16:2276–2283. Smith R, Walker R. 1964 Femoral expansion in aging women: implications for osteoporosis and fractures. Science 145:156–157. Ruff C, Hayes W. 1982 Subperiosteal expansion and cortical remodeling of the human femur and tibia with aging. Science 217:945–947. Seeman E. 2002 Pathogenesis of bone fragility in women and men. Lancet 359:1841–1850. Ruff C, Hayes W. 1988 Sex differences in age-related remodeling of the femur and tibia. J Orthop Res 6:886–896. Beck TJ, Ruff CB, Bissessur K. 1993 Age-related changes in female femoral neck geometry: implications for bone strength. Calcif Tissue Int 53(Suppl 1):S41-S6. Seeman, E. 1997 From density to structure: growing up and growing old on the surfaces of bone. J Bone Miner Res 12:509–521. Riggs BL, Melton Iii LJ, 3rd, Robb RA, et al 2004 Population-based study of age and sex differences in bone volumetric density, size, geometry, and structure at different skeletal sites. J Bone Miner Res 19:1945–1954. Gibson L. 1985 The mechanical behaviour of cancellous bone. J Biomech 18:317–328. Hildebrand T, Laib A, Muller R, Dequeker J, Ruegsegger P. 1999 Direct three-dimensional morphometric analysis of human cancellous bone: microstructural data from spine, femur, iliac crest, and calcaneus. J Bone Miner Res 14:1167–1174. Majumdar S, Kothari M, Augat P, et al. 1998 High-resolution magnetic resonance imaging: three-dimensional trabecular bone architecture and biomechanical properties. Bone 22:445–454. Genant HK, Gordon C, Jiang Y, et al. 2000 Advanced imaging of the macrostructure and microstructure of bone. Horm Res 54(Suppl 1):24–30. Link TM, Majumdar S. 2004 Current Diagnostic Techniques in the Evaluation of Bone Architecture. Curr Osteoporos Rep 2:47–52. Wehrli FW, Saha PK, Gomberg BR, et al. 2002 Role of magnetic resonance for assessing structure and function of trabecular bone. Top Magn Reson Imaging 13: 335–355. Müller R. 2003 Bone microarchitecture assessment—current and future trends. Osteoporosis Int 14(Suppl 5):S73-S80. Goulet R, Goldstein S, Ciarelli M, Kuhn J, Brown M, Feldkamp L. 1994 The relationship between the structural and orthogonal compressive properties of trabecular bone. J Biomech 27:375–389. Bouxsein M, Radloff S. 1997 Quantitative ultrasound of the calcaneus reflects the material properties of calcaneal trabecular bone. J Bone Miner Res 12:839–846. Goldstein S, Goulet R, McCubbrey D. 1993 Measurement and significance of three-dimensional architecture to the mechanical integrity of trabecular bone. Calcif Tissue Int 53(Suppl 1):S127-S133. Snyder BD, Hayes WC. 1990 Multiaxial structure-property relations in trabecular bone. In: Mow VC, Ratcliffe A, Woo SL-Y (eds) Biomechanics of Diarthrodial Joints. Springer, New York, pp. 31–59. Ulrich D, van Rietbergen B, Laib A, Ruegsegger P. 1999 The ability of three-dimensional structural indices to reflect mechanical aspects of trabecular bone. Bone 25:55–60. Silva MJ, Gibson LJ. 1997 Modeling the mechanical behavior of vertebral trabecular bone: effects of age-related changes in microstructure. Bone 21:191–199. van der Linden JC, Homminga J, Verhaar JA, Weinans H. 2001 Mechanical consequences of bone loss in cancellous bone. J Bone Miner Res 16:457–465. Yeh OC, Keaveny TM. 1999 Biomechanical effects of intraspecimen variations in trabecular architecture: a three-dimensional finite element study. Bone 25:223–228. Bell GH, Dunbar O, Beck JS. 1967 Variations in strength of vertebrae with age and their relation to osteoporosis. Calcif Tissue Res 1:75–86. Parfitt A. 1984 Age-related structural changes in trabecular and cortical bone: cellular mechanisms and biomechanical consequences. Calcif Tissue Int 36(S):123–128. Ciarelli TE, Fyhrie DP, Schaffler MB, Goldstein SA. 2000 Variations in three-dimensional cancellous bone architecture of the proximal femur in female hip fractures and in controls. J Bone Miner Res 15:32–40. Legrand E, Chappard D, Pascaretti C, et al. 2000 Trabecular bone microarchitecture, bone mineral density, and vertebral fractures in male osteoporosis. J Bone Miner Res 15:13–19. Link TM, Lotter A, Beyer F, et al. 2000 Changes in calcaneal trabecular bone structure after heart transplantation: an MR imaging study. Radiology 217:855–862. Aaron JE, Shore PA, Shore RC, Beneton M, Kanis JA. 2000 Trabecular architecture in women and men of similar bone mass with and without vertebral fracture: II. Three-dimensional histology [In Process Citation]. Bone 27: 277–282. Dufresne TE, Chmielewski PA, Manhart MD, Johnson TD, Borah B. 2003 Risedronate preserves bone architecture in early postmenopausal women in 1 year as measured by three-dimensional microcomputed tomography. Calcif Tissue Int 73:423–432. Borah B, Dufresne TE, Chmielewski PA, Johnston TD, Chines A, Manhart MD. 2004 Risedronate preserves bone architecture in postmenopausal women with osteoporosis as measured by three-dimensional microcomputed tomography. Bone 34:736–746. Dempster DW, Cosman F, Kurland ES, e al. 2001 Effects of daily treatment with parathyroid hormone on bone microarchitecture and turnover in patients with osteoporosis: a paired biopsy study. J Bone Miner Res 16:1846–1853. Jiang Y, Zhao JJ, Mitlak BH, Wang O, Genant HK, Eriksen EF. 2003 Recombinant human parathyroid hormone (1–34) [teriparatide] improves both cortical and cancellous bone structure. J Bone Miner Res 18:1932–1941. Currey J. 1969 The mechanical consequences of variation in the mineral content of bone. J Biomech 2:1–11. Currey JD. 1999 What determines the bending strength of compact bone? J Exp Biol 202:2495–2503. Turner CH. 2002 Biomechanics of bone: determinants of skeletal fragility and bone quality. Osteoporosis Int 13: 97–104. Meunier PJ, Arlot M, Chavassieux P, Yates AJ. 1999 The effects of alendronate on bone turnover and bone quality. Int J Clin Pract Suppl 101:14–17. Meunier PJ, Boivin G. 1997 Bone mineral density reflects bone mass but also the degree of mineralization of bone: therapeutic implications. Bone 21:373–377. Boivin GY, Chavassieux PM, Santora AC, Yates J, Meunier PJ. 2000 Alendronate increases bone strength by increasing the mean degree of mineralization of bone tissue in osteoporotic women. Bone 27:687–694. Roschger P, Rinnerthaler S, Yates J, Rodan GA, Fratzl P, Klaushofer K. 2001 Alendronate increases degree and uniformity of mineralization in cancellous bone and decreases the porosity in cortical bone of osteoporotic women. Bone 29:185–191. Boivin G, Lips P, Ott SM, et al. 2003 Contribution of raloxifene and calcium and vitamin D3 supplementation to the increase of the degree of mineralization of bone in postmenopausal women. J Clin Endocrinol Metab 88:4199–4205. Boivin G, Meunier PJ. 2003 Methodological considerations in measurement of bone mineral content. Osteoporos Int 14(Suppl 5):S22-S28. Misof BM, Roschger P, Cosman F, et al. 2003 Effects of intermittent parathyroid hormone administration on bone mineralization density in iliac crest biopsies from patients with osteoporosis: a paired study before and after treatment. J Clin Endocrinol Metab 88:1150–1156. Delmas PD. 2000 How does antiresorptive therapy decrease the risk of fracture in women with osteoporosis? Bone 27:1–3. Dempster DW. 2002 The impact of bone turnover and bone-active agents on bone quality: focus on the hip. Osteoporos Int 13:349–352. Currey J. 2003 Role of collagen and other organics in the mechanical properties of bone. Osteoporos Int 14(Suppl 5):S29-S36. Mann V, Hobson EE, Li B, et al. 2001 A COL1A1 Sp1 binding site polymmorphism predisposes to osteoporotic fracture by affecting bone density and quality. J Clin Invest 107:899–907. Efstathiadou Z, Tsatsoulis A, Ioannidis JP. 2001 Association of collagen Ialpha 1 Sp1 polymorphism with the risk of prevalent fractures: a meta-analysis. J Bone Miner Res 16:1586–1592. Schaffler M. 2003 Role of bone turnover in microdamage. Osteoporos Int 14:tbd. Parfitt AM. 2002 Targeted and nontargeted bone remodeling: relationship to basic multicellular unit origination and progression. Bone 30:5–7. Burr DB. 2002 Targeted and nontargeted remodeling. Bone 30:2–4. Cheng X, Lowet G, Boonen S, et al. 1997 Assessment of the strength of proximal femur in vitro: relationship to femoral bone mineral density and femoral geometry. Bone 20:213–218. Nicholson P, Lowet G, Cheng X, Boonen S, van der Perre G, Dequeker J. 1997 Assessment of the strength of the proximal femur in vitro: relationship with ultrasonic measurements of the calcaneus. Bone 20:219–224. Cheng XG, Nicholson PH, Boonen S, et al. 1997 Prediction of vertebral strength in vitro by spinal bone densitometry and calcaneal ultrasound. J Bone Miner Res 12:1721–1728. Lochmuller EM, Eckstein F, Kaiser D, et al. 1998 Prediction of vertebral failure loads from spinal and femoral dual-energy X-ray absorptiometry, and calcaneal ultrasound: an in situ analysis with intact soft tissues Bone 23:417–424. Lochmuller EM, Zeller JB, Kaiser D, et al. 1998 Correlation of femoral and lumbar DXA and calcaneal ultrasound, measured in situ with intact soft tissues, with the in vitro failure loads of the proximal femur. Osteoporos Int 8:591–598. Bouxsein ML. 2005 Determinants of skeletal fragility. In: Reid D, Geusens P (eds) Best Practice & Research, Clinical Rheumatology. Rapid Medical Media, Eastbourne, East Sussex, UK, pp. 897–912.