title: A biomechanical analysis of the effects of resorption cavities on cancellous bone strength.
abstract: We evaluated the effects of resorption cavities on cancellous bone strength using computational methods. Adding cavities to cancellous bone caused reductions in strength and stiffness that were greater than expected from the associated changes in bone volume and more pronounced when cavities were targeted to regions of high tissue strain.
  
  
  BACKGROUND
  The amount of bone turnover in the skeleton has recently been implicated as a factor influencing bone strength. One mechanism proposed to explain this effect is that resorption cavities reduce the effective thickness of trabeculae and modify local stress distributions leading to reduced mechanical performance of the entire structure. In this study, we tested the plausibility of this mechanism.
  
  
  METHODS
  High-resolution finite element models were created from muCT images of 16 vertebral cancellous bone samples, as well as from images of the samples in which cavities had been added digitally-either at regions of high strain (targeted) or placed at random on the bone surface (nontargeted). The effect of resorption cavities on predicted bone strength and stiffness was evaluated by comparing the relationships between mechanical properties and bone volume fraction among the three groups (the original images, those with nontargeted cavities, and those with targeted cavities).
  
  
  RESULTS
  Addition of resorption cavities modified the relationship between mechanical properties and bone volume fraction in the finite element models such that, for a given bone volume fraction, stiffness and yield strength were reduced compared with the original images (p < 0.05). The differences in yield strength-volume fraction relationships between the original models and those with targeted cavities were significantly greater than those between the original models and those with nontargeted cavities (p < 0.05). None of the differences in predicted mechanical properties per unit bone volume fraction could be accounted for by 3D measures of microarchitecture.
  
  
  CONCLUSIONS
  Resorption cavities may influence cancellous bone strength and stiffness independent of their effect on bone volume. The effects of cavities on bone mechanical performance relative to bone volume are greater when cavities are targeted to regions of high strain and cannot be predicted using standard microarchitecture measures.
authors.affiliation: Department of Mechanical Engineering, Orthhopaedic Biomechanics Laboratory, University of California, Berkeley, CA, USA. christopher.hernandez@case.edu
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Hernandez
authors.forename: Atul
authors.initials: A
authors.lastname: Gupta
authors.forename: Tony M
authors.initials: TM
authors.lastname: Keaveny
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D001862:Bone Resorption / Q000000981:diagnostic imaging / Q000473:pathology*; D019245:Compressive Strength; D003198:Computer Simulation; D005260:Female; D020342:Finite Element Analysis; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed