以主应力作为力学激励的骨再造方程

我们在分析目前现有的骨再造理论的基础上,根据Thomas Brown的实验结果,结合有限元方法,提出以主应力作为力学激励,决定骨功能性适应重建的形态或密度变化,建立了基于主应力的骨重建方程,并通过对正畸中倾斜移动进行模拟,结果能定性地反映临床观察中牙槽骨的重建现象.     

骨功能适应性重建模型及数值模拟

骨骼会受到力学因素的影响和调控,发生骨功能适应性重建。建立模拟骨重建的数值模型,定量地研究骨重建过程,有着重要的临床应用价值。目前,骨功能适应性重建模型可分为两大类：力学模型和生理模型。对这两类重建模型的原理、算法和应用等做详细论述。力学模型通过假设力学环境与骨结构之间的函数关系来预测骨重建,但不考虑其真实的生物学过程。基于不同的重建激励主要有两种力学模型：骨力学稳态模型和骨损伤修复模型。生理模型则试图从微观层次阐明骨重建的力学-生物学机制,骨重建是由破骨细胞、成骨细胞等各种骨组织细胞完成,有以基本多细胞单位的形式作用或细胞独立分开作用两种观点。这些重建模型结合有限元法应用在许多有关骨重建问题的数值计算中。通过比较分析多个数值应用的模拟结果,还讨论了重建控制方程中各参数值的设置对重建结果的影响。     

基于损伤修复的骨重建数值模拟

目的 研究不同损伤情况下的骨重建行为.方法 提出一种疲劳机制作用下的骨重建模型,通过建立股骨近端三维有限元模型,并结合有限元法,分别模拟3种载荷工况下的骨重建情况,分析股骨近端的力学性能及密度变化.结果 通过增加载荷循环次数,使损伤不断增加.在不同损伤情况下,骨展现出不同的骨重建行为.骨重建作为一种修复机制,在一定范围内可以弥补由于疲劳损伤造成的骨量丢失.结论 提出的损伤自适应重建模型可以模拟不同损伤情况下的骨重建行为,以及由于载荷循环次数过大引起的过载吸收.研究疲劳损伤作用下的骨重建行为,可以为骨折预防以及术后康复治疗提供参考.     

骨骼肌通过力学刺激对骨重建的影响

骨骼与骨骼肌作为运动系统最重要的组织,两者之间存在密切的联系。骨肌单元的概念提出已久,运动产生的力学负荷将两者紧密地联系在一起。骨骼为骨骼肌施力提供力学支撑,而骨骼肌收缩带动机体的运动。在机体运动过程中,骨骼肌充当力学负荷与骨骼之间的中间媒介,并通过内分泌因子以及力学信号调节骨骼的代谢活动,与机体内持续不断的骨重建密切相关,并维持骨骼良好的结构和功能。主要综述近年来骨骼肌通过对骨骼施加力学刺激影响骨重建作用的研究进展,为预防和治疗骨代谢疾病提供新的思路。     

振动对骨重建影响的三维有限元分析

目的观察不同振动频率刺激下股骨表观密度的变化情况,从而确定何种振动参数能对骨骼系统产生最有益影响。方法先获得兔股骨扫描图像,再利用UG软件对图像进行三维重建得到股骨的实体模型,最后导入ANSYS软件中,利用ANSYS软件布尔操作中的减操作,得到带有空腔的兔股骨生物力学模型。结果通过有限元仿真分析,发现添加振动激励后骨骼的应力分布和骨密度发生了变化,股骨部分部位骨密度增加。结论有限元分析不但为分析振动对骨重建的动物和人体实验打下基础,还为进一步深入了解骨骼结构与力学环境之间的关系、为进一步研究对抗航天失重引起的骨丢失和治疗骨质疏松症提供了帮助。     

低载荷下耦合电刺激的骨重建数值模拟

目的 考虑电场影响的同时研究骨在低载荷刺激频率下的废用行为。方法 提出一个废用模型并通过参数激活频率来描述力学刺激与电刺激对骨重建过程的影响。通过建立股骨近端有限元模型,结合有限单元法,模拟低载荷刺激频率下耦合电刺激的骨重建过程,并分析骨密度的流失情况。结果 降低日载荷刺激频率会显著降低骨密度。电刺激可以在一定程度上抵抗由于低载荷刺激频率导致的密度流失,其主要影响区域分布在股骨头部与股骨颈部。电刺激持续时长会显著影响骨皮质与骨松质的密度流失情况。结论 模型可以模拟由于日载荷刺激频率降低导致的废用过程;同时,纳入了电场影响表现其抵抗密度流失的现象。     

力学刺激通过microRNA调控骨重建的研究进展

骨骼结构完整性和骨量的维持需要一定的力学刺激。研究表明,力学刺激可通过调控多种调节因子(例如激素、转录因子和信号分子等)参与骨重建过程。力学刺激可以通过调控微小RNA(microRNA,miRNA)表达在骨重建过程中起着至关重要的作用。然而,受力学刺激调控的miRNA在骨重建过程中的作用和机制尚不完全清楚。本文综述受力学刺激调控的miRNA在骨重建过程中的作用及其机制,并强调其在治疗骨质疏松中的潜在应用。     

单侧下颌骨牵张成骨的数值模拟

目的针对颜面短小患者建立下颌骨及咀嚼肌模型,通过有限元方法研究牵张成骨过程中下颌骨的形变规律,并与患者实际手术效果进行对比,为类似病例的治疗过程提出改进意见。方法依据临床颜面短小患者原始数据,结合MIMICS医学影像控制系统软件,运用三维重建技术构造患者下颌骨及咀嚼肌的实体结构,最后导入ANSYS有限元软件完成单侧下颌骨延长的有限元模型,并模拟手术效果。结果所建立的术前术后有限元分析模型具有数字化、个性化特征。结论数值模拟结果与手术效果进行对比,重合度较好,可以为不同病情的病人术前提供个性化的手术指导。     

步态水平对髋关节假体周围骨重建的影响

目的 针对髋关节置换术后患者步态运动水平变化,研究假体周围骨密度（bone mineral density, BMD）变化率的变化趋势,揭示置换初期、长期运动变化对骨重建的影响规律。方法 基于自适应骨重建理论,建立股骨-假体有限元模型,以术后初期、长期步态水平作为重建参数计算假体周围BMD分布,采用Gruen分区方法量化BMD的变化。结果 术后初期,恒定步态组与变化步态组BMD存在明显差异,最大差异发生在低步态组中,造成大转子区域BMD减小41%;步态运动提高促进假体近端、中端BMD变化,显著影响发生在大转子区域,造成BMD增加47%;术后长期阶段,步态运动提高促进假体中端、末端区域BMD恢复,BMD增加2%～9%。结论 研究结果为髋关节置换后患者康复过程提供指导。     

动载荷作用下骨重建力学调控机制

目的探讨动载荷作用下骨重建的力学调控机制。方法对骨重建力学调控机制进行分析,吸纳力学疲劳强度理论思想,提出动载荷作用下骨重建力学调控机制;选取损伤作为力学激励,建立动载荷骨重建模型;分析动态载荷成骨效果优于静态载荷现象,数值模拟运动防治骨质疏松。结果动态载荷成骨效果优于静态载荷现象得到较为合理的解释;运动量增加10%~30%,骨密度增加3.13%~8.61%。结论动载荷作用下骨重建的力学调控机制可为机械振动防治骨代谢相关疾病提供理论指导,是骨重建力学调控理论的补充和完善。     

股骨头内松质骨空间分布和力学性能变化有限元分析

目的应用有限元方法研究不同加载强度和偏轴角对股骨头内松质骨空间分布和力学性能变化的影响。方法基于断层磨削后扫描、计算机三维重建的方法建立得到股骨近端骨结构三维模型,按照与主压力小梁方向成0°、15°、45°分别选取相同大小的松质骨试件。计算试件的三维空间结构参数,应用有限元分析方法模拟单轴压缩试验,观察松质骨试件应力、应变分布,探讨不同加载强度和离轴角度对松质骨生物力学性质的影响。结果基于建立的人股骨头内松质骨三维有限元模型,模拟了松质骨试件单轴压缩试验,发现不同加载强度和偏轴角度在松质骨试件中≥5 000με(微应变)的松质骨比例存在统计学差异(P0.05)。结论股骨头内松质骨小梁空间分布与力学适应性密切相关。结构与功能的不相适应降低了股骨头内部松质骨的生物力学性能,反复不良刺激引起的骨重塑、改建可能在股骨头坏死中起着重要的作用。     

Bone remodeling regulation under unloading conditions: Numerical investigations

The present paper addresses the following question: can a simple regulatory bone remodeling model predict effects of unloading conditions on the trabecular bone morphology? In an attempt to answer this question, rat tail-suspension was chosen as a model that mimics the microgravity environment. Over 23 days, histomorphometric analysis was carried out on cross-sections of tibias of the suspended animals. The slices were digitalized and images discretized to obtain osteocyte distribution and apparent bone density. Based on these experimental data, finite element simulations were conducted to evaluate the bone loss and the change in trabecular architecture similar to those observed after a spaceflight. The numerical model is driven by a remodeling law that takes into account the nonuniform osteocyte distribution that may itself provide mechanoreception. We used the bone density rate of change from the remodeling theory and a time stepping algorithm witch are implemented in a finite element software.This approach takes into account the unloading effects on bone remodeling process and permits to confront experimental and numerical data. We showed that there is a good agreement between these data, particularly at the beginning of the simulated bone mass loss during the rat tail-suspension experiment. Indeed, we obtained a variation of 5.25% at day 7 (D7), 2.09% at day 13 (D13) and finally, 51.03% at day 23 (D23). Despite that last variation, the proposed theoretical model can be suitable to simulate the alteration of bone mineral density under the specific unloading conditions of the rat tail-suspension model.     

骨组织工程化构建中细胞三维培养力学微环境的研究

骨重建和骨塑建的力学响应机制表明力学因素在骨的组织工程化构建中起着十分重要的作用。外部力学载荷导致骨组织内部的力学微环境发生变化进而在细胞的增殖、迁移、细胞外基质的合成、细胞因子及激素分泌能力以及骨髓间充质干细胞的分化方向等方面产生重要的影响。因此,在组织工程构建过程中,细胞三维培养的力学微环境是有待深入研究的重要内容。尤其近年来引入了三维有限元分析的方法以及非侵入性高分辨率的Micro-CT影像技术,使在细观层次上进一步探索培养物内部的微观力学条件成为可能。综述了骨组织工程化构建中细胞三维培养的微环境、力学生物学效应、力学因素的施加和量化等方面的研究进展。     

Metaphyseal sleeves in revision total knee arthroplasties: Computational analysis of bone remodeling

BackgroundMetaphyseal sleeves help maintain long term stability and reduce revision rate for aseptic loosening in total knee arthroplasty (TKA) revision. However, their performance regarding bone remodeling is still poorly known for the long term. This study aimed to investigate the impact of metaphyseal sleeves on the bone remodeling of the tibia.MethodsFive finite element models of a female tibia with different implant configurations (regarding stem length and metaphyseal sleeve application) were developed. Loading conditions included joint reaction force, muscle, and tibia-fibula loads from 6 instances of the gait cycle. The bone remodeling model applied was adapted to the subject under analysis by selecting the bone remodeling parameters that best replicated the bone density distribution of the tibia estimated from the CT data. Changes in bone density after TKA were evaluated in 8 regions of interest.ResultsGlobal bone loss ranged from −31.16%, in 115 mm stemmed configurations, to −20.93%, in 75 mm stemmed configurations. Apart from the lateral and posterior regions in the proximal tibia, whose bone loss reduced and increased, respectively, due to the incorporation of a metaphyseal sleeve, changes in bone density were similar with and without a metaphyseal sleeve for each stem length.ConclusionThe results suggest that bone remodeling of the tibia is not critically affected by the incorporation of metaphyseal sleeves. Considering that sleeves are believed to present a favorable clinical outcome in stability and osseointegration, reducing the revision rate for aseptic loosening, their advantages seem to outweigh their disadvantages regarding bone remodeling.     

Parametric sensitivity analysis applied to a specific one-dimensional internal bone remodelling problem

The relative importance of the various parameters in inducing bone mass loss and osteoclastic perforations is still controversial. Therefore, there is a significant motivation to better understand the parameters behind such dynamic response, and great interest to carry out a parametric sensitivity study as it can provide useful information. As an application, the widely-accepted bone remodelling equation [M.G. Mullender, R. Huiskes, H. Weinans, A physiological approach to the simulation of bone remodeling as self organizational control process, J. Biomech. 27 (1994) 1389.] is investigated using the "n units" model [M. Zidi, S. Ramtani, Bone remodeling theory applied to the study of n unit-elements model, J Biomech. 32 (1999) 743.]. This analysis pointed out that the power in the modulus density relationship p and the power to which density is raised in normalizing the energy stimulus q, known as strongly implicated in the stability condition of the remodelling process, were also stated as insensitive parameters in the bone loss area.     

Computer simulation of an adaptive damage-bone remodeling law applied to three unit-bone bars structure

It is well admitted that the mechanical loading plays an important role in the growth and maintenance of our skeleton, and that microdamage (i.e.: microcracks) occurs naturally when the bone is overloaded during day-to-day activities. It is also argued, from experimental and theoretical viewpoint, that the cells which built and rebuilt the skeleton are sensitive for both strain and microdamage. The recent damage-bone remodeling theory is employed here to study the mechanical response of the three unit-bone bars that simulate bone trabeculae in the form of truss. It is shown that under constant load, such a structure exhibit inhomogeneous strain and it's response to external applied load depends strongly upon the manner in which the microdamage is distributed.     

Biomechanical consequences of progressive marginal bone loss around oral implants: a finite element stress analysis

The purpose of this study was to explore the biomechanical effects of progressive marginal bone loss in the peri-implant bone. Finite element model of a Ø 4.1 × 10 mm Straumann dental implant and a solid abutment was constructed as predefined eight-layers around the implant neck. The implant-abutment complex was embedded in a cylindrical bone model to analyze bone biomechanics regardless of anatomical influences. Angular and circular progressive marginal bone loss was simulated by sequential removal of each layer, resulting crater-like defects and a total of ten finite element models for analysis. Each model was subjected to a vertical and oblique static load of 100 N in separate load cases. Principal stress minimum and maximum, displacement, and equivalent of elastic strain outcomes were compared. Under vertical loading, principal stresses minimum and maximum decreased remarkably as with the increase in bone resorption. Under oblique load simulations, decrease in principal stress maximum and minimum was evident. With progressive bone loss and under oblique load simulations, displacement and equivalent of elastic strain increased considerably in trabecular bone contacting the implant neck. The presence of cortical bone contacting a load-carrying implant, even in a bone defect, improves the biomechanical performance of implants in comparison with only trabecular bone support as a sequel of progressive marginal bone loss.     

The effect of friction on indenter force and pile-up in numerical simulations of bone nanoindentation

Nanoindentation is a useful technique for probing the mechanical properties of bone, and finite element (FE) modeling of the indentation allows inverse determination of elastoplastic constitutive properties. However, all but one FE study to date have assumed frictionless contact between indenter and bone. The aim of this study was to explore the effect of friction in simulations of bone nanoindentation. Two-dimensional axisymmetric FE simulations were performed using a spheroconical indenter of tip radius 0.6 μm and angle 90°. The coefficient of friction between indenter and bone was varied between 0.0 (frictionless) and 0.3. Isotropic linear elasticity was used in all simulations, with bone elastic modulus and Poisson’s ratio of 0.3. Plasticity was incorporated using both Drucker–Prager and von Mises yield surfaces. Friction had a modest effect on the predicted force–indentation curve for both von Mises and Drucker–Prager plasticity, reducing maximum indenter displacement by 10% and 20% respectively as friction coefficient was increased from zero to 0.3 (at a maximum indenter force of 5 mN). However, friction has a much greater effect on predicted pile-up after indentation, reducing predicted pile-up from 0.27 to 0.11 μm with a von Mises model, and from 0.09 to 0.02 μm with Drucker–Prager plasticity. We conclude that it is potentially important to include friction in nanoindentation simulations of bone if pile-up is used to compare simulation results with experiment.     

Bone remodeling in the resurfaced femoral head: Effect of cement mantle thickness and interface characteristics

Metal-on-metal hip resurfacing prostheses were re-introduced during the last 10–15 years. These prostheses have the potential to better restore normal function with limited activity restriction, being an option for younger and more active patients. Resurfacing procedures have demonstrated high failure rates in national registers [1], [2]. Multiple factors may affect early and long-term HR performance. The influence of femoral cement mantle thickness and different interface characteristics between the prosthesis components on the long-term performance of resurfacing prostheses is still unknown. In the present work, a model was used to predict bone remodeling with different mantle thicknesses and interface characteristics. A very thin cement mantle (0.25 mm) increased bone resorption at the superior femoral head, while greater thickness (1 or 3 mm) had a lesser effect. In all cases, bone apposition was predicted around the stem and at the stem tip. Bone formation and resorption were observed clinically in good agreement with the predictions calculated in simulations. Computed results showed that 1-mm cement mantle thickness combined with a bonded bone–cement interface and a debonded implant–cement interface was an appropriate configuration. Bone remodeling results and computed equivalent strains were correlated. In conclusion, we have been able to demonstrate the importance of choosing an adequate cement mantle thickness. Additionally, computational studies should consider realistic interface characteristics between the components in order to perform simulations closer to reality.     

基于应力状态的细胞分子水平骨重建力生物学模型

目的建立基于应力状态的细胞分子水平骨重建力生物学模型。方法从工程角度分析骨重建过程和力学激励,吸纳力学强度设计理论思想,选取相当应力作为力学激励,基于应力状态选取合适的力学激励计算公式,提出基于应力状态的细胞分子水平骨重建力生物学模型;应用模型进行口腔临床正畸牙槽骨的模拟预测。结果张力区孔隙度降低,骨量增加;压力区孔隙度增加,骨量减少,与牙槽骨特性一致。结论基于应力状态的细胞分子水平骨重建力生物学模型考虑应力状态对骨组织失效形式的影响,体现骨重建过程是力学激励下细胞水平的自优化强度设计,有助于在细胞分子水平探讨应力状态对骨重建的影响,是骨重建理论的补充和完善,可为口腔正畸的治疗提供理论指导。