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Trabecular Bone Mechanical Properties in Patients with Fragility Fractures

  • Symposium: Biomechanics of Bone Healing
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Fragility fractures are generally associated with substantial loss in trabecular bone mass and alterations in structural anisotropy. Despite the high correlations between measures of trabecular mass and mechanical properties, significant overlap in density measures exists between individuals with osteoporosis and those who do not fracture. The purpose of this paper is to provide an analysis of trabecular properties associated with fragility fractures. While accurate measures of bone mass and 3-D orientation have been demonstrated to explain 80% to 90% of the variance in mechanical behavior, clinical and experimental experience suggests the unexplained proportion of variance may be a key determinant in separating high- and low-risk patients. Using a hierarchical perspective, we demonstrate the potential contributions of structural and tissue morphology, material properties, and chemical composition to the apparent mechanical properties of trabecular bone. The results suggest that the propensity for an individual to remodel or adapt to habitual damaging or nondamaging loads may distinguish them in terms of risk for failure.

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Acknowledgments

We thank Peggy Piech for her contributions to this manuscript. We acknowledge the scientific contributions of Dr. Barbara McCreadie and Dr. Traci Ciarelli from discussions and reviews of their research.

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  1. Department of Orthopaedic Surgery, Orthopaedic Research Laboratories, University of Michigan, 2001 Biomedical Science Research Building (BSRB), 109 Zina Pitcher Place, Ann Arbor, MI, 48109, USA

    Jaclynn M. Kreider MS & Steven A. Goldstein PhD

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  1. Jaclynn M. Kreider MS
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Correspondence to Steven A. Goldstein PhD.

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Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. Funding from the wide variety of studies summarized in this paper was provided from grants from the National Institutes of Health, the National Science Foundation, and the Whitaker Foundation.

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Kreider, J.M., Goldstein, S.A. Trabecular Bone Mechanical Properties in Patients with Fragility Fractures. Clin Orthop Relat Res 467, 1955–1963 (2009). https://doi.org/10.1007/s11999-009-0751-8

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