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WHOLE BONE MECHANICS
Motivated by the need to better understand the etiology of osteoporotic
bone fractures, one major goal is to determine the effects of damage to
trabecular bone - which may occur during a non-fracturing fall or very
strenuous activities - on the strength of whole bones such as the proximal
femur and vertebral body. A unique aspect of this work is our ability to
incorporate our constitutive data for the mechanical behavior of intact
and damaged trabecular bone tissue - measured using our accurate testing
techniques described above - into these whole bone structural analyses,
enabling us to develop highly accurate models of the real whole bone. In
this way, there is a synergistic effect between our work on bone at the
tissue and organ levels.
In collaboration with researchers at the Orthopaedic
Biomechanics Laboratory (Beth Israel Hospital, Boston) we have refined
our finite element modeling capability of the human spine. Comparing bone-specific
finite element models with the real structure tested to failure mechanically,
we found that locations of trabecular failure corresponded closely with
regions of high strain (as opposed to high stress). We have also shown
that the role of the cortical shell is minimal in the vertebral body, but
that the anisotropy of the trabecular centrum is important to consider
in finite element modeling of these complex systems. The results from these
fundamental studies, in addition to developing our intuition for the complex
mechanics of the vertebral body, have provided the framework from which
we can now construct three-dimensional models of the whole spine from computed
tomography scans with confidence of valid model predictions. Cuurent work
in our laboratory is directed towards refining these analyses and developing
methods to include the effects of damaged bone in our models. This work
is funded by an ongoing NIH FIRST award.
Similar studies have been performed for the proximal femur and are now
being performed for the facial skeleton (Figure). Using these models, for
example, we have quantified stress distributions in the facial skeleton
for various habitual loads, and have determined the effects of various
surgical procedures and pathologies on these stresses. We are also initiating
a collaboration with researchers from San Francisco General Hospital to
incorporate aspects of fall dynamics into models of the proximal femur
in order to better identify patients at risk of osteoporotic fracture.
This work combines our expertise in bone mechanics with that of our collaborators
in energy absorption and fall dynamics for the proximal femur.
ABOVE: Human facial skeleton
model used in finite element
modeling.
Relevant Publications
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Mizrahi J, Silva MJ, Keaveny TM, Edwards WT, and Hayes WC: Finite element
stress analysis of the normal and osteoporotic lumbar spine. Spine, 18:2088Ð2096,
1993.abstract
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Silva MJ, Wang C, Keaveny TM, and Hayes WC: Direct and computed tomography
thickness measurements of the human vertebral shell and endplate. Bone,
15:409-414, 1994.abstract
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Ford, CM , Keaveny, TM and Hayes WC: The effect of impact direction on
the structural capacity of the proximal femur during falls, Journal of
Bone and Mineral Research, 11:377-383, 1996.
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Keaveny TM, Jaloszynski RL, and Murphy SB: The importance of stresses in
the etiology of slipped capital femoral epiphysis. Trans. Orthopaedic Research
Society 1993, 704.
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Silva MJ, Wang C, and Keaveny TM: Direct thickness measurements of the
vertebral body shell and endplate. Trans. Orthopaedic Research Society
1993, 401.
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Silva MJ, Keaveny TM, and Hayes WC: Load sharing between cortical and trabecular
bone in the lumbar vertebral body. Trans. Orthopaedic Research Society
1994, 426.
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Silva MJ, Keaveny TM, and Hayes WC: CT-based finite element analysis predicts
failure loads and fracture patterns for vertebral sections. Trans. Orthopaedic
Research Society 1996, 273.
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Klisch SM, Duncan NA, Keaveny TM, and Lotz JC: The relative effects of
disc water content and bone modulus on vertebral body stresses. Proc. ISSLS
(Int Soc. for the Study of the Lumbar Spine), June 25-29, Burlington VT,
1996, 68.
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