Institute for Biomechanics, ETH Zürich, , Wolfgang-Pauli-Strasse 10, 8093 Zürich, Switzerland.
Philos Trans A Math Phys Eng Sci. 2010 Jun 13;368(1920):2653-68. doi: 10.1098/rsta.2010.0041.
The risk of osteoporotic fractures is currently estimated based on an assessment of bone mass as measured by dual-energy X-ray absorptiometry. However, patient-specific finite element (FE) simulations that include information from multiple scales have the potential to allow more accurate prognosis. In the past, FE models of bone were limited either in resolution or to the linearization of the mechanical behaviour. Now, nonlinear, high-resolution simulations including the bone microstructure have been made possible by recent advances in simulation methods, computer infrastructure and imaging, allowing the implementation of multiscale modelling schemes. For example, the mechanical loads generated in the musculoskeletal system define the boundary conditions for organ-level, continuum-based FE models, whose nonlinear material properties are derived from microstructural information. Similarly microstructure models include tissue-level information such as the dynamic behaviour of collagen by modifying the model's constitutive law. This multiscale approach to modelling the mechanics of bone allows a more accurate characterization of bone fracture behaviour. Furthermore, such models could also include the effects of ageing, osteoporosis and drug treatment. Here we present the current state of the art for multiscale modelling and assess its potential to better predict an individual's risk of fracture in a clinical setting.
目前，骨质疏松性骨折的风险是基于双能 X 射线吸收法测量的骨量评估来估计的。然而，包含来自多个尺度信息的患者特定有限元（FE）模拟有可能允许更准确的预后。过去，骨骼的 FE 模型要么在分辨率上受限，要么在力学行为上线性化。现在，由于模拟方法、计算机基础设施和成像方面的最新进展，已经可以进行非线性、高分辨率的模拟，包括骨骼微结构，从而实现了多尺度建模方案。例如，在肌肉骨骼系统中产生的机械载荷定义了基于器官的连续 FE 模型的边界条件，其非线性材料特性源自微观结构信息。同样，微观结构模型包括组织级信息，例如通过修改模型的本构定律来动态模拟胶原蛋白的行为。这种骨骼力学的多尺度建模方法允许更准确地描述骨骼骨折行为。此外，此类模型还可以包括老化、骨质疏松症和药物治疗的影响。在这里，我们介绍了多尺度建模的最新现状，并评估了其在临床环境中更好地预测个体骨折风险的潜力。
