Feng Chenglong, Zhang Ke, Zhan Shi, Gan Yuxiong, Xiang Xinhao, Niu Wenxin
Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China.
Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China.
Front Bioeng Biotechnol. 2024 Sep 9;12:1448708. doi: 10.3389/fbioe.2024.1448708. eCollection 2024.
Osteoporosis-induced changes in bone structure and composition significantly reduce bone strength, particularly in the human proximal femur. This study examines how these changes affect the mechanical performance of trabecular bone to enhance diagnosis, prevention, and treatment strategies.
A proximal femur sample was scanned using micro-CT at 40 μm resolution. Five regions of interest were selected within the femoral head, femoral neck, and greater trochanter. Structural models simulating various stages of osteoporosis were created using image processing software. Micro-finite element analysis evaluated the mechanical properties of trabecular bone under different conditions of structural deterioration and tissue-level elastic modulus variations. The combined effects of structural deterioration and tissue-level mechanical properties on trabecular bone mechanical performance were further analyzed.
The mechanical performance of trabecular bone generally follows a power-law relationship with its microstructural characteristics. However, in any specific region, the apparent mechanical properties linearly decrease with structural deterioration. The femoral neck and greater trochanter are more sensitive to structural deterioration than the femoral head. A 5% bone mass loss in the femoral head led to a 7% reduction in mechanical performance, while the femoral neck experienced a 12% loss. Increasing tissue-level elastic modulus improved mechanical performance, partially offsetting bone mass reduction effects.
Trabecular bone in low bone mass regions is more affected by bone mass loss. Structural deterioration primarily reduces bone strength, but improvements in tissue-level properties can mitigate this effect, especially in early osteoporosis. Targeted assessments and interventions are crucial for effective management. Future research should explore heterogeneous deterioration models to better understand osteoporosis progression.
骨质疏松症引起的骨骼结构和成分变化会显著降低骨强度，尤其是在人类股骨近端。本研究探讨这些变化如何影响小梁骨的力学性能，以加强诊断、预防和治疗策略。
使用微计算机断层扫描以40微米分辨率扫描一个股骨近端样本。在股骨头、股骨颈和大转子内选择五个感兴趣区域。使用图像处理软件创建模拟骨质疏松症各个阶段的结构模型。微观有限元分析评估了在结构退化和组织水平弹性模量变化的不同条件下小梁骨的力学性能。进一步分析了结构退化和组织水平力学性能对小梁骨力学性能的综合影响。
小梁骨的力学性能通常与其微观结构特征呈幂律关系。然而，在任何特定区域，表观力学性能会随着结构退化而线性下降。股骨颈和大转子比股骨头对结构退化更敏感。股骨头骨质流失5%导致力学性能下降7%，而股骨颈则下降12%。增加组织水平弹性模量可改善力学性能，部分抵消骨质减少的影响。
低骨量区域的小梁骨受骨质流失的影响更大。结构退化主要降低骨强度，但组织水平性能的改善可以减轻这种影响，尤其是在早期骨质疏松症中。有针对性的评估和干预对于有效管理至关重要。未来的研究应探索异质性退化模型，以更好地了解骨质疏松症的进展。
