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All bones comprise an outer layer of compact bone, and an interior made up of spongy bone tissue, also called cancellous or trabecular bone. In long bones, spongy bone tissue is mainly found in the interior of the epiphyses (broad ends of the bone).
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Most bones contain compact and spongy osseous tissue, but their distribution and concentration vary based on the bone's overall function.
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Bone contains a relatively small number of cells entrenched in a matrix of collagen fibers that provide an adherent surface for inorganic salt crystals. Both components of the matrix, organic and inorganic, contribute to the unusual properties of bone. Without collagen, bones would be brittle and shatter easily. Without mineral crystals, bones would flex and provide little support. This can be observed by an experiment: when the minerals of a bone are dissolved by soaking the bone in...
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Does cancellous screw insertion torque depend on bone mineral density and/or microarchitecture?

Rosidah Ab-Lazid1, Egon Perilli1, Melissa K Ryan1

  • 1Medical Device Research Institute, School of Computer Science, Engineering and Mathematics, Flinders University, GP.O. Box 2100, Adelaide, South Australia 5001, Australia.

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|December 24, 2013
PubMed
Summary

Plateau torque predicts screw insertion failure and strongly correlates with bone density and microarchitecture in human femoral heads. This finding is crucial for understanding bone quality and screw fixation.

Keywords:
Bone mineral densityMaximum torqueMicroarchitecturePlateau torqueScrew insertion

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Area of Science:

  • Orthopedic biomechanics
  • Bone tissue engineering
  • Surgical implantology

Background:

  • Plateau torque (T(Plateau)) predicts cancellous bone screw insertion failure (stripping) and correlates with bone density in animal models.
  • The relationship between T(Plateau), areal bone mineral density (aBMD), and bone microarchitecture in human bone remains unexplored.

Purpose of the Study:

  • To investigate the dependence of T(Plateau) on aBMD and bone microarchitecture in human femoral heads.
  • To assess T(Plateau) as a predictor of insertion failure torque in human bone.

Main Methods:

  • Excised human femoral heads (n=52) were analyzed for aBMD and microarchitecture using DXA and micro-CT.
  • Cancellous screws were inserted using a micro-mechanical test device to measure T(Plateau) from insertion profiles.
  • Correlation and regression analyses were performed to evaluate relationships between T(Plateau), aBMD, and microarchitectural parameters.

Main Results:

  • T(Plateau) showed the strongest correlation with structure model index (SMI, R=-0.82), followed by bone volume fraction (BV/TV, R=0.80) and aBMD (R=0.76).
  • Regression models combining aBMD with microarchitectural parameters (SMI, BV/TV, BS/TV) significantly improved the prediction of T(Plateau) (R² increased from 0.58 to 0.74).
  • T(Plateau) demonstrated significant dependence on human femoral head microarchitecture and aBMD.

Conclusions:

  • T(Plateau) is a significant predictor of screw insertion failure torque in human bone.
  • Bone microarchitecture, particularly SMI and BV/TV, along with aBMD, are critical determinants of T(Plateau) in human femoral heads.
  • These findings highlight the importance of bone microarchitecture in predicting screw fixation performance.