Advanced multi-scale mechanobiological simulations enable the distinction between healthy and pathological bone growth patterns
Abstract
Introduction & Purpose
Bones adapt its shape and strength in response to mechanical loading. Tissue-level mechanical stresses, i.e., hydrostatic compressive stress and octahedral shear stress, regulate biological events on the cellular and molecular level, and thereby impact tissue histomorphology and changes in bony geometry (Carter & Beaupré, 2007). Mechanobiological multi-scale simulations based on gait analysis data, musculoskeletal (MSK) modelling and finite element (FE) analysis enable to estimate tissue-level bone loads and predict growth patterns (Shefelbine & Carter, 2004). Such simulations have the potential to inform clinical decision-making in patients with pathological bone deformations, e.g. increased femoral anteversion angle (AVA), which are common in children with cerebral palsy (CP). However, the time-consuming process of creating subject-specific models has previously restricted studies to small sample sizes (n = 1-4 participants), thereby limiting the generalizability of findings (Carriero et al., 2011; Yadav et al., 2021). Moreover, the simulations have not been validated directly due to a lack of longitudinal experimental data, which hinders the widespread use and implementation in clinical settings. Over the last years, we focused our research efforts to overcome these hurdles. We developed a workflow to streamline the process to create subject-specific FE model (Koller et al., 2023). In this study we aimed to use this workflow and 1) analyze growth…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,320 participants or records.
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