Mechanical consequences of bone loss in cancellous bone
Mechanical consequences of bone loss in cancellous bone
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DOI：
10.1359/jbmr.2001.16.3.457
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发表时间：
2001-03-01
影响因子：
6.2
通讯作者：
Weinans, H
中科院分区：
文献类型：
--
作者：
van der Linden, JC;Homminga, J;Weinans, H
骨骼在骨重建过程中不断更新。这可以防止损坏的累积，并使架构适应外部负载。副作用是随着年龄的增长，骨量、强度和刚度逐渐下降。我们使用三维（3D）计算机模型研究了骨丢失对松质骨的载荷分布和力学性能的影响。模拟了几种骨丢失情况。在整个结构中，在高应变、低应变和随机位置去除骨基质。此外，还模拟了骨小梁的吸收腔和变薄。在高应变位置去除7%的骨量对机械性能有有害影响，而在低应变位置可以去除高达50%的骨量。因此，如果仅在可能需要修复的高度应变位置开始重塑，则松质骨将持续处于骨折的风险中。骨小梁变薄导致刚度相对较小的降低;由再吸收腔引起的相同的骨损失导致腔底部的刚度和高应变峰值的大幅降低，这解释了在抗再吸收药物治疗中再吸收腔的数量和尺寸的减少可以导致骨折风险的大幅降低，而骨量的小幅增加，空腔周围的小梁中的应变增加高达1000个微应变，这可能导致骨沉积。这些结果提供了在骨小梁水平上骨重建和骨吸收的力学效应的见解。
The skeleton is continuously being renewed in the bone remodeling process. This prevents accumulation of damage and adapts the architecture to external loads. A side effect is a gradual decrease of bone mass, strength, and stiffness with age. We investigated the effects of bone loss on the load distribution and mechanical properties of cancellous bone using three-dimensional (3D) computer models. Several bone loss scenarios were simulated. Bone matrix was removed at locations of high strain, of low strain, and random throughout the architecture. Furthermore, resorption cavities and thinning of trabeculae were simulated. Removal of 7% of the bone mass at highly strained locations had deleterious effects on the mechanical properties, while up to 50% of the bone volume could be removed at locations of low strain. Thus, if remodeling would be initiated only at highly strained locations, where repair is likely needed, cancellous bone would be continuously at risk of fracture. Thinning of trabeculae resulted in relatively small decreases in stiffness; the same bone loss caused by resorption cavities caused large decreases in stiffness and high strain peaks at the bottom of the cavities, This explains that a reduction in the number and size of resorption cavities in antiresorptive drug treatment can result in large reductions in fracture risk, with small increases in bone mass, Strains in trabeculae surrounding a cavity increased by up to 1000 microstrains, which could lead to bone apposition. These results give insight in the mechanical effects of bone remodeling and resorption at trabecular level.