Comparison of a manual and motorized stiffness meter to quantify bone regeneration in distraction osteogenesis

To assess bone healing and investigate the influence of different pharmaceutics (e.g. growth factors) on bone stiffness and strength in-vivo, new quantitative methods are necessary. Therefore, a new manual and motorized stiffness meter to quantify bone regeneration in a model of distraction osteogenesis were compared. The design, equipment, and improvements of the measurement devices are described. Furthermore, their difference in precision and accuracy in comparison to tests from a material testing system, used as "gold standard", were evaluated. Both devices were able to assess regenerate stiffness: the accuracy ranged between +/- 9% for the manual and +/-5% for the motorized version for stiffness data over 0.1 Nm/ degrees; precision between +/- 3.8% for the manual and +/- 3.2% for the motorized device. In summary, the two stiffness measurement devices described in this study have the power to monitor the beginning of bone healing and therefore predict the load bearing capacity of regenerating bone. The motorized version showed advantages over the manual device when investigating and monitoring the stiffness of bone during a consolidation period: (1) better accuracy in both stiffness below and above 0.1 Nm/ degrees, (2) a better precision in the stiffness range of interest, (3) easier handling, and (4) standardisation of the measurement process using the stepper motor and definition of the maximums of torque, angulation and rotation speed.