Material properties are related to stress fracture callus and porosity of cortical bone tissue at affected and unaffected sites
Corresponding Author
Rachel C. Entwistle
J.D. Wheat Veterinary Orthopedic Research Laboratory, School of Veterinary Medicine, Stover Lab, University of California–Davis, 1285 Veterinary Drive, Bldg VM3A, Rm 4206, Davis, California 95616
J.D. Wheat Veterinary Orthopedic Research Laboratory, School of Veterinary Medicine, Stover Lab, University of California–Davis, 1285 Veterinary Drive, Bldg VM3A, Rm 4206, Davis, California 95616. T: 530-754-6979; F: 530-754-0150.Search for more papers by this authorSara C. Sammons
J.D. Wheat Veterinary Orthopedic Research Laboratory, School of Veterinary Medicine, Stover Lab, University of California–Davis, 1285 Veterinary Drive, Bldg VM3A, Rm 4206, Davis, California 95616
Search for more papers by this authorRobert F. Bigley
Orthopedic Research Laboratories, School of Medicine, University of California at Davis, Sacramento, California
Search for more papers by this authorScott J. Hazelwood
Biomedical and General Engineering Department, California Polytechnic State University, San Luis Obispbo, California
Search for more papers by this authorDavid P. Fyhrie
Orthopedic Research Laboratories, School of Medicine, University of California at Davis, Sacramento, California
Search for more papers by this authorJeffery C. Gibeling
Department of Chemical Engineering and Materials Science, University of California at Davis, Davis, California
Search for more papers by this authorSusan M. Stover
J.D. Wheat Veterinary Orthopedic Research Laboratory, School of Veterinary Medicine, Stover Lab, University of California–Davis, 1285 Veterinary Drive, Bldg VM3A, Rm 4206, Davis, California 95616
Search for more papers by this authorCorresponding Author
Rachel C. Entwistle
J.D. Wheat Veterinary Orthopedic Research Laboratory, School of Veterinary Medicine, Stover Lab, University of California–Davis, 1285 Veterinary Drive, Bldg VM3A, Rm 4206, Davis, California 95616
J.D. Wheat Veterinary Orthopedic Research Laboratory, School of Veterinary Medicine, Stover Lab, University of California–Davis, 1285 Veterinary Drive, Bldg VM3A, Rm 4206, Davis, California 95616. T: 530-754-6979; F: 530-754-0150.Search for more papers by this authorSara C. Sammons
J.D. Wheat Veterinary Orthopedic Research Laboratory, School of Veterinary Medicine, Stover Lab, University of California–Davis, 1285 Veterinary Drive, Bldg VM3A, Rm 4206, Davis, California 95616
Search for more papers by this authorRobert F. Bigley
Orthopedic Research Laboratories, School of Medicine, University of California at Davis, Sacramento, California
Search for more papers by this authorScott J. Hazelwood
Biomedical and General Engineering Department, California Polytechnic State University, San Luis Obispbo, California
Search for more papers by this authorDavid P. Fyhrie
Orthopedic Research Laboratories, School of Medicine, University of California at Davis, Sacramento, California
Search for more papers by this authorJeffery C. Gibeling
Department of Chemical Engineering and Materials Science, University of California at Davis, Davis, California
Search for more papers by this authorSusan M. Stover
J.D. Wheat Veterinary Orthopedic Research Laboratory, School of Veterinary Medicine, Stover Lab, University of California–Davis, 1285 Veterinary Drive, Bldg VM3A, Rm 4206, Davis, California 95616
Search for more papers by this authorAbstract
Stress fractures are overuse injuries of bone that affect elite athletes and military recruits. One response of cortical bone to stress fracture is to lay down periosteal callus. The objectives of this study were to determine if material properties are different among bones with different stages of stress fracture callus, at both a callus site and at a distal site. Cortical specimens were mechanically tested to determine their stress–strain response. Material property differences were examined using nonparametric and regression analyses. At the callus site, material properties were low during the earliest stages of callus, higher with increasing callus maturity, but dropped at the late stage of callus. At the distal site, the material properties were low during early stages of callus and approached, or returned to, those of bones without callus during the late stages of callus. The effects of stress fracture and bone callus are not limited to the focal site of stress fracture. © 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27:1272–1279, 2009
REFERENCES
- 1 Hsieh YF, Silva MJ. 2002. In vivo fatigue loading of the rat ulna induces both bone formation and resorption and leads to time-related changes in bone mechanical properties and density. J Orthop Res 20: 764–771.
- 2 Wallace JM, Rajachar RM, Allen MR, et al. 2007. Exercise-induced changes in the cortical bone of growing mice are bone- and gender-specific. Bone 40: 1120–1127.
- 3 Lieberman DE, Pearson OM, Polk JD, et al. 2003. Optimization of bone growth and remodeling in response to loading in tapered mammalian limbs. J Exp Biol 206: 3125–3138.
- 4 Schaffler MB, Radin EL, Burr DB. 1989. Mechanical and morphological effects of strain rate on fatigue of compact bone. Bone 10: 207–214.
- 5 Burr DB, Martin RB, Schaffler MB, et al. 1985. Bone remodeling in response to in vivo fatigue microdamage. J Biomech 18: 189–200.
- 6 Hetsroni I, Finestone A, Milgrom C, et al. 2008. The role of foot pronation in the development of femoral and tibial stress fractures: a prospective biomechanical study. Clin J Sport Med 18: 18–23.
- 7 Valimaki VV, Alfthan H, Lehmuskallio E, et al. 2005. Risk factors for clinical stress fractures in male military recruits: a prospective cohort study. Bone 37: 267–273.
- 8 Hame SL, LaFemina JM, McAllister DR, et al. 2004. Fractures in the collegiate athlete. Am J Sports Med 32: 446–451.
- 9 Iwamoto J, Takeda T. 2003. Stress fractures in athletes: review of 196 cases. J Orthop Sci 8: 273–278.
- 10 Verheyen KL, Wood JL. 2004. Descriptive epidemiology of fractures occurring in British Thoroughbred racehorses in training. Equine Vet J 36: 167–173.
- 11 Kraus BM, Ross MW, Boswell RP. 2005. Stress remodeling and stress fracture of the humerus in four standardbred racehorses. Vet Radiol Ultrasound 46: 524–528.
- 12 Carrier TK, Estberg L, Stover SM, et al. 1998. Association between long periods without high-speed workouts and risk of complete humeral or pelvic fracture in thoroughbred racehorses: 54 cases (1991–1994). J Am Vet Med Assoc. 212: 1582–1587.
- 13 Riggs CM, Whitehouse GH, Boyde A. 1999. Pathology of the distal condyles of the third metacarpal and third metatarsal bones of the horse. Equine Vet J 31: 140–148.
- 14 Stover SM, Johnson BJ, Daft BM, et al. 1992. An association between complete and incomplete stress fractures of the humerus in racehorses. Equine Vet J 24: 260–263.
- 15 Stover SM, Ardans AA, Read DH, et al. 1993. Patterns of stress fractures associated with complete bone fractures in racehorses. 39th Annual American Association of Equine Practitioners (AAEP) Convention.
- 16 Fredericson M, Jennings F, Beaulieu C, et al. 2006. Stress fractures in athletes. Top Magn Reson Imaging 17: 309–325.
- 17 Gustafson MB, Martin RB, Gibson V, et al. 1996. Calcium buffering is required to maintain bone stiffness in saline solution. J Biomech 29: 1191–1194.
- 18 Entwistle RC. 2008. Relationships of stress fracture syndrome, bone microstructural features, and exercise history with material properties of humeri from thoroughbred racehorses. In: Biomedical engineering. Davis, CA: University of California, Davis.
- 19 Martin RB, Gibson VA, Stover SM, et al. 1997. Residual strength of equine bone is not reduced by intense fatigue loading: implications for stress fracture. J Biomech 30: 109–114.
- 20 Callahan J, Hoffman K. 1995. Calculus in context: The Five College Calculus Project. New York: W.H. Freeman & Company.
- 21 Cruess RL, Dumont J. 1975. Fracture healing. Can J Surg 18: 403–413.
- 22 Nalla RK, Kinney JH, Ritchie RO. 2003. Mechanistic fracture criteria for the failure of human cortical bone. Nat Mater 2: 164–168.
- 23 Burstein AH, Zika JM, Heiple KG, et al. 1975. Contribution of collagen and mineral to the elastic-plastic properties of bone. J Bone Joint Surg Am 57: 956–961.
- 24 Zioupos P, Currey JD, Sedman AJ. 1994. An examination of the micromechanics of failure of bone and antler by acoustic emission tests and Laser Scanning Confocal Microscopy. Med Eng Phys 16: 203–212.
- 25 O'Sullivan CB, Lumsden JM. 2003. Stress fractures of the tibia and humerus in Thoroughbred racehorses: 99 cases (1992–2000). J Am Vet Med Assoc. 222: 491–498.
- 26 Perneger TV. 1998. What's wrong with Bonferroni adjustments. Br Med J 316: 1236.