Inter-trabecular bone formation: a specific mechanism for healing of cancellous bone

Figures & data

Figure 1. Photograph of a micro-dissected biopsy taken 4 weeks after knee arthrodesis, comprising the junction between the femur and tibia. Note the spatially limited bone formation. From Charnley and Baker (1952) with permission.

Figure 2. A drawing of the main bone-forming process in inter-trabecular bone formation; condensations of mesenchymal cells forming osteoid, which becomes woven bone.

Figure 3. Inter-trabecular bone formation 7 days after a drill hole (dotted line) in the proximal tibia of a mouse. A. Histology. B. MicroCT (not the the same sample).

Figure 4. Inter-trabecular bone formation in human distal radius 16 days after fracture. T indicates old trabeculae.

Figure 5. The principle behind most available models for mechanical testing of cancellous healing. Red denotes the area that contributes to the mechanical properties measured.

Published models that allow mechanical evaluation of cancellous healing

Model	Authors	Animal	Evaluation method	Pros	Cons
Osteotomy, plate fixation	Histing et al. 2012	Mouse	Torsion	No external callus, no cartilage	Few trabeculae, large variance
Osteotomy, intramedullary pin	Tu et al. 2014	Mouse	3-point bending	Simple	Few trabeculae, external callus, cartilage, large variance
Osteotomy, plate fixation	Stuermer et al. 2010	Rat	3-point bending	Trabecular rich area, small variance	External callus
Drill defect	Uusitalo et al. 2001	Mouse	3-point bending	Trabecular rich area, small variance, no external callus, simple	Cartilage, unloaded
Osteotomy, plate fixation	Alt et al. 2013	Rat	3-point bending	Trabecular rich area	External callus, large variance
Partial osteotomy, external fixation	Tsiridis et al. 2007	Rabbit	Torsion followed by compression	Small variance, both torsion and compression	Large animal, few trabeculae, external callus
Drill defect, screw insertion	Skoglund et al. 2004, Sandberg and Aspenberg 2015	Rat, mouse	Pullout test	Simple, no external callus, no cartilage, trabecular rich area, small variance	Implant to bone interaction, unloaded

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Alt V, Thormann U, Ray S, Zahner D, Durselen L, Lips K, et al. A new metaphyseal bone defect model in osteoporotic rats to study biomaterials for the enhancement of bone healing in osteoporotic fractures. Acta Biomater 2013; 9 (6): 7035–42.

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Skoglund B, Holmertz J, Aspenberg P. Systemic and local ibandronate enhance screw fixation. J Orthop Res 2004; 22 (5): 1108–13.

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