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Microindentation - a tool for measuring cortical bone stiffness? A systematic review.

M Arnold1, S Zhao1, S Ma2

  • 1Imperial College London, The MSk Lab, Imperial College London, Charing Cross Hospital, London W6 8RF, UK.

Bone & Joint Research
|September 20, 2017
PubMed
Summary

Microindentation shows promise for measuring bone stiffness, crucial for implant stability. However, conflicting results from limited studies mean more research is needed to confirm its accuracy for cortical bone stiffness assessment.

Keywords:
Cortical BoneMicroindentationStiffness

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Area of Science:

  • Biomechanical Engineering
  • Orthopaedic Surgery
  • Materials Science

Background:

  • Bone stiffness is vital for orthopaedic implant press-fit stability.
  • Accurate bone stiffness measurement could prevent complications like periprosthetic fractures.
  • Microindentation offers a potential method for assessing patient-specific bone stiffness.

Purpose of the Study:

  • To systematically review the literature on microindentation's accuracy in measuring cortical bone stiffness.
  • To evaluate the current evidence supporting microindentation as a reliable tool for bone stiffness assessment.

Main Methods:

  • A systematic review of English-language articles was conducted using major scientific databases (Medline, Embase, PubMed, Scopus, Cochrane).
  • Studies focused on microindentation of cortical bone were included, excluding nanoindentation, cancellous bone, and animal studies.
  • Data from 32 selected papers were analyzed, categorizing indentation techniques and comparing results.

Main Results:

  • 32 studies were analyzed, utilizing reference point indentation (RPI) or traditional depth-sensing indentation.
  • Several factors influence microindentation accuracy, including tip size, depth, and analysis method.
  • Only two studies validated microindentation against mechanical testing, yielding contradictory findings on RPI's correlation with established methods.

Conclusions:

  • Current evidence on microindentation's accuracy for cortical bone stiffness is limited and conflicting.
  • Further research comparing microindentation with established mechanical testing techniques is essential.
  • Reliable clinical application of microindentation for cortical bone stiffness assessment requires more robust validation.