Theoretical relationship between maximum pore size and toughness in experimental inflammatory arthritis

Rheumatoid arthritis increases the risk of fracture. In an animal model of inflammatory arthritis, femoral diaphysis had a decreased toughness as well as increased cortical porosity, when compared to normal bone. Based on the hypothesis that stress concentration from the large porous defects reduces the ability of the cortical bone to resist failure, this work determined if the changes observed in porosity could explain the changes observed in toughness. Using theoretical relationships of the stress concentration and stress states, a model of the observed conditions was considered. A relationship was developed that indicated the relative difference in toughness between normal and arthritic specimens as a function of pore size. Results indicated that the increase in cortical pore size could theoretically reduce toughness by 55%. This decrease compares with the experimentally observed drop in toughness of 61%. Furthermore, the critical parameter for fracture in this situation is the ratio of pore diameter to cortical thickness. Efforts to reduce cortical porosity seen in inflammatory arthritis would be effective in enhancing the toughness of bone and may reduce morbidity in a human population.