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Mechanical stability in a human radius fracture treated with a novel tissue-engineered bone substitute: a non-invasive, longitudinal assessment using high-resolution pQCT in combination with finite element analysis.
MedLine Citation:
PMID:  20827669     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The clinical gold standard in orthopaedics for treating fractures with large bone defects is still the use of autologous, cancellous bone autografts. While this material provides a strong healing response, the use of autografts is often associated with additional morbidity. Therefore, there is a demand for off-the-shelf biomaterials that perform similar to autografts. Biomechanical assessment of such a biomaterial in vivo has so far been limited. Recently, the development of high-resolution peripheral quantitative computed tomography (HR-pQCT) has made it possible to measure bone structure in humans in great detail. Finite element analysis (FEA) has been used to accurately estimate bone mechanical function from three-dimensional CT images. The aim of this study was therefore to determine the feasibility of these two methods in combination, to quantify bone healing in a clinical case with a fracture at the distal radius which was treated with a new bone graft substitute. Validation was sought through a conceptional ovine model. The bones were scanned using HR-pQCT and subsequently biomechanically tested. FEA-derived stiffness was validated relative to the experimental data. The developed processing methods were then adapted and applied to in vivo follow-up data of the patient. Our analyses indicated an 18% increase of bone stiffness within 2 months. To our knowledge, this was the first time that microstructural finite element analyses have been performed on bone-implant constructs in a clinical setting. From this clinical case study, we conclude that HR-pQCT-based micro-finite element analyses show high potential to quantify bone healing in patients. Copyright © 2010 John Wiley & Sons, Ltd.
Authors:
Thomas L Mueller; Andreas J Wirth; G Harry van Lenthe; Joerg Goldhahn; Jason Schense; Virginia Jamieson; Peter Messmer; Daniel Uebelhart; Dominik Weishaupt; Marcus Egermann; Ralph Müller
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Publication Detail:
Type:  Journal Article     Date:  2010-09-08
Journal Detail:
Title:  Journal of tissue engineering and regenerative medicine     Volume:  5     ISSN:  1932-7005     ISO Abbreviation:  J Tissue Eng Regen Med     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101308490     Medline TA:  J Tissue Eng Regen Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  415-20     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 John Wiley & Sons, Ltd.
Affiliation:
Institute for Biomechanics, ETH Zurich, Zurich, Switzerland.
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