Cancellous bone architecture: advantages of nonorthogonal trabecular alignment under multidirectional joint loading.

Wolff proposed that trabeculae align at 90 degrees angles (orthogonal). However, nonorthogonal alignment of trabeculae has been observed near many joints, including the proximal femur. We propose that nonorthogonal alignment is an adaptation to multidirectional joint loads. When the loading direction does not correspond with the trabecular alignment, warping or shear coupling occurs leading to large shear strains within the cancellous structure. Using a simplified continuum model for trabecular bone, we demonstrate that shear coupling caused by multidirectional joint loads is reduced 33-75% when trabeculae are aligned 60 degrees from one another (as is observed in regions of the proximal femur), as opposed to 90 degrees from one another (as was predicted by Wolff). The results suggest that an optimal cancellous structure may appear differently under multidirectional joint loads than the 'trajectorial' organization proposed by Wolff, which was based upon assumptions drawn from unidirectional loading.