Abstract:
This
paper
characterizes
the
state
of
art
in
the
mechanical
properties
of
bone
and
seeks
new
avenues
aligned
with
non-invasive
characterizations
to
better
fit
and
produce
innovative
technologies
within
the
biomedical
implant
field
and
early
detection
of
bone
diseases.
It
is
concluded
that
the
combination
of
these
methods
and
non-invasive
techniques
contributes
significantly
to
obtain
the
mechanical
properties
of
the
bones,
which
could
be
extremely
useful
in
the
early
detection
of
bone
diseases,
developing
biological
models,
and
performing
mechanical
analysis
with
the
intent
to
predict
abnormal
biological
behaviors
in
human
beings.
Keywords:
bone,
non-Invasive
techniques,
mechanical
properties,
biomaterials.
ISSN-E:
2737-6439
Athenea
Journal
Vol.3,
Núm.
10,
(pp.
16-29)
Vélez-Cruz & Fariñas-Coronado.
Review-Bone Characterization: Mechanical Properties Based on Non-Destructive Techniques
Velez-Cruz,
Alex
J.
alvelez@pupr.edu
https://orcid.org/0000-0002-9289-5256
Polytechnic
University
of
Puerto
Rico
San
Juan,
PR-USA
Fariñas-Coronado,
Wilfredo
wfarinas@pupr.edu
h
t
t
p
s
:
/
/
o
r
c
i
d
.
o
r
g
/
0
0
0
0
-
0
0
0
3
-
2
0
9
5
-
5
7
5
5
Polytechnic
University
of
Puerto
Rico
San
Juan,
PR-USA
Universidad
Nacional
Experimental
Politecnica
“Antonio
Jose
de
Sucre”
Vice-Rectorado,
Puerto
Ordaz
Estado
Bolívar-Venezuela
Resumen:
Este
artículo
caracteriza
el
estado
del
arte
en
las
propiedades
mecánicas
del
hueso
y
busca
nuevas
avenidas
las
cuales
estén
alineadas
con
caracterizaciones
no
invasivas
para
que
así
se
puedan
adaptarse
mejor
y
producir
tecnologías
de
vanguardia
dentro
del
campo
de
implantes
biomédicos
y
detección
temprana
de
enfermedades
en
los
huesos.
Se
concluye
que
la
combinación
de
estos
métodos
y
técnicas
no
invasivas
contribuye
significativamente
a
obtener
las
propiedades
mecánicas
de
los
huesos,
lo
cuales
pudieran
ser
de
gran
utilidad
para
la
detección
temprana
de
enfermedades
óseas,
el
desarrollo
de
modelos
biológicos
y
la
realización
de
análisis
mecánicos
con
la
intención
de
predecir
comportamientos
biológicos
anormales
en
los
seres
humanos.
Palabras
Clave:
hueso,
técnicas
no-invasivas,
propiedades
mecánicas,
biomateriales.
.
Caracterización
de
Huesos:
Propiedades
Mecánicas
Basadas
en
Técnicas
No-
Destructivas
16
R
e
c
i
b
i
d
o
(
1
2
/
0
3
/
2
0
2
2
)
,
A
c
e
p
t
a
d
o
(
0
5
/
0
6
/
2
0
2
2
)
Review-Bone Characterization:
Mechanical Properties Based on Non-
Destructive Techniques
https://doi.org/10.47460/athenea.v3i10.45
I. INTRODUCTION
.
The
field
of
prosthetics
operates
under
largely
empirical
knowledge.
Artificial
limbs
are
expensive,
but
without
a
p
r
o
p
e
r
f
i
t
,
t
h
e
s
e
h
i
g
h
-
t
e
c
h
a
p
p
e
n
d
a
g
e
s
a
r
e
w
o
r
t
h
l
e
s
s
—
a
p
o
o
r
l
y
a
t
t
a
c
h
e
d
p
r
o
s
t
h
e
s
i
s
i
s
n
o
t
j
u
s
t
uncomfortable
and
painful,
it
can
also
further
injure
a
patient
and
create
another
type
of
problems
for
their
s
k
i
n
a
n
d
m
u
s
c
u
l
o
s
k
e
l
e
t
a
l
s
y
s
t
e
m
d
i
s
c
u
s
s
e
d
o
n
[
1
]
.
T
o
d
a
y
,
s
t
a
t
e
-
o
f
-
t
h
e
-
a
r
t
p
r
o
s
t
h
e
t
i
c
s
a
r
e
m
e
c
h
a
n
i
c
a
l
l
i
m
b
s
controlled
by
nerve
impulses
and
microprocessors.
While
these
enhancements
can
make
life
easier
for
amputees,
a
cutting-edge
limb
alone
will
not
suffice,
they
must
fit
properly.
A
high-tech
limb
with
an
unsecured
interface
can
fall
off
or
cause
unnecessary
energy
loss
between
a
living
limb
and
artificial
extension.
To
ensure
a
perfect
fit,
patients
need
to
go
for
multiple
moldings,
and
they
require
routine
adjustments.
But
even
with
all
the
expense
and
effort
put
into
a
good
fit,
most
of
the
time
limbs
are
attached
with
simple
suction
or
skin
traction
presented
on
[2].
There
are
several
options
that
could
avoid
these
types
of
problems,
and
in
particular,
a
method
that
uses
biomaterials
would
allow
for
tried
and
validated
applications.
Osseointegration,
the
process
of
surgically
grafting
an
artificial
limb
onto
a
living
bone
as
indicated
in
[3],
ensures
the
greatest
energy
transfer
and
fit
between
the
body
and
the
prosthesis.
A
limb
is
attached
over
two
s
u
r
g
e
r
i
e
s
.
D
u
r
i
n
g
t
h
e
f
i
r
s
t
p
r
o
c
e
d
u
r
e
,
a
t
i
t
a
n
i
u
m
s
c
r
e
w
i
s
i
n
s
e
r
t
e
d
i
n
t
o
t
h
e
m
a
r
r
o
w
o
f
t
h
e
r
e
s
i
d
u
a
l
l
i
m
b
.
S
e
v
e
r
a
l
months
later,
when
this
screw
has
become
successfully
integrated
into
the
bone,
doctors
add
an
extension
to
w
h
i
c
h
t
h
e
p
r
o
s
t
h
e
s
i
s
w
i
l
l
a
t
t
a
c
h
.
This
process
would
use
engineered
materials
in
its
application.
The
integration
of
these
materials
necessitates
a
way
in
which
the
patient
can
be
evaluated
non-invasively,
and
a
procedure
or
plan
can
be
formulated
and
tailored
to
the
individual.
This
would
require
streamlining
the
process
to
a
few
points
of
data
from
which
the
plan
for
the
prosthetic
is
generated.
These
consist
of
the
engineering
mechanics
of
bones
and
joints,
the
physical
characteristics
of
the
patient,
the
kind
of
use
the
prosthetic
will
have,
and
the
life
of
the
product
desired.
While
some
of
these
details
can
be
answered
on
a
questionnaire,
others
need
to
be
obtained
through
observation.
An
important
part
of
this
process
is
to
neither
hurt
the
musculoskeletal
nor
the
skin
of
the
patient,
so
this
necessitates
a
non-invasive
method
of
collecting
data
about
bones
and
joints.
This
would
allow
us
to
calculate,
using
known
engineering
characteristics
of
bone,
a
near
as
possible
perfect
implementation
of
osseointegration.
II. FIELDS OF INTEREST TO THE SUBJECT
A.
A
Brief
Review:
Biomaterials
This
review
discusses
the
factors
important
in
the
incorporation
or
integration
of
biomaterials
and
devices
by
tissue.
Methods
for
surface
modification
and
surface-sensitive
techniques
for
analysis
are
cited.
In
vitro
methods
to
evaluate
the
biocompatibility
or
efficacy
of
certain
biomaterials
and
devices
are
presented
in
[4].
Present
and
future
directions
in
neural
prostheses,
cardiovascular
materials,
blood
or
bone
substitutes,
controlled
drug
delivery,
orthopedic
prostheses,
dental
materials,
artificial
organs,
plasma
and
cytopheresis,
and
dialysis
are
discussed
in
[5],
[6].
B.
Characterization
of
Bone
Material
Properties
and
Microstructure
in
Osteogenesis
Imperfect
/
Brittle
Bone
Disease
Nanoindentation
was
used
to
examine
the
longitudinal
elastic
modulus
and
hardness
at
the
material
level
for
mild
Osteogenesis
Imperfect
(OI)
type
I
vs.
severe
OI
type
III.
Both
modulus
and
hardness
were
significantly
higher
(by
7%
and
8%,
respectively)
in
mild
OI
cortical
bone
compared
to
the
more
severe
phenotype.
Lamellar
microstructure
also
affected
these
properties,
as
the
younger
bone
material
immediately
surrounding
osteons
showed
decreased
modulus
(13%)
and
hardness
(11%)
compared
to
the
older
interstitial
material
seen
in
[7].
17
Vélez-Cruz & Fariñas-Coronado.
Review-Bone Characterization: Mechanical Properties Based on Non-Destructive Techniques
ISSN-E:
2737-6439
Athenea
Journal
Vol.3,
Núm.
10,
(pp.
16-29)
A
h
i
g
h
-
r
e
s
o
l
u
t
i
o
n
m
i
c
r
o
-
c
o
m
p
u
t
e
d
t
o
m
o
g
r
a
p
h
y
s
y
s
t
e
m
u
t
i
l
i
z
i
n
g
s
y
n
c
h
r
o
t
r
o
n
r
a
d
i
a
t
i
o
n
(
S
R
µ
C
T
)
w
a
s
d
e
s
c
r
i
b
e
d
and
used
to
analyze
the
microscale
vascular
porosity,
osteocyte
lacunar
morphometry,
and
bone
mineral
density
in
OI
vs.
healthy
individuals.
Vascular
porosity,
canal
diameter,
and
osteocyte
lacunar
density
were
all
two
to
six
times
higher
in
OI
cortical
bone.
Osteocytes
were
also
more
spherical
in
shape.
Finally,
three-point
bending
techniques
were
used
to
evaluate
the
microscale
mechanical
properties
of
OI
cortical
bone
in
two
different
orientations.
Elastic
modulus,
flexural
yield
strength,
ultimate
strength,
and
crack-growth
toughness
were
three
to
six
times
higher
in
specimens
whose
pore
structure
was
primarily
oriented
parallel
vs.
perpendicular
to
the
long
bone
axis.
There
was
also
a
strong
negative
correlation
between
the
elevated
vascular
porosity
of
OI
cortical
bone
and
its
elastic
modulus,
flexural
yield
strength,
and
ultimate
s
t
r
e
n
g
t
h
.
T
h
i
s
r
e
l
a
t
i
o
n
s
h
i
p
w
a
s
i
n
d
e
p
e
n
d
e
n
t
o
f
o
s
t
e
o
c
y
t
e
l
a
c
u
n
a
r
d
e
n
s
i
t
y
a
n
d
t
i
s
s
u
e
m
i
n
e
r
a
l
d
e
n
s
i
t
y
.
In
summary,
these
findings
highlight
new
material
and
microstructural
changes
within
OI
cortical
bone
that
help
contribute
to
its
fragility.
They
also
underscore
a
deep
connection
between
bone
structure
and
mechanical
integrity
at
multiple
length
scales.
B.
Predicting
regional
variations
in
trabecular
bone
mechanical
properties
within
the
human
proximal
tibia
using
MR
imaging
Recent
studies
have
shown
that
high-resolution
magnetic
resonance
(MR)
imaging
allows
3D
characterization
of
bone
microstructure.
Using
MR,
whole
joint
images
may
be
acquired
with
details
of
both
bone
and
the
s
u
r
r
o
u
n
d
i
n
g
s
o
f
t
t
i
s
s
u
e
.
W
h
i
l
e
M
R
i
s
n
o
t
a
b
l
e
t
o
m
e
a
s
u
r
e
t
h
e
a
m
o
u
n
t
o
f
m
i
n
e
r
a
l
s
i
n
t
h
e
b
o
n
e
a
s
d
e
t
e
r
m
i
n
e
d
i
n
X-ray-based
imaging
modalities
that
measure
bone
mineral
density
(BMD),
it
is
possible
to
distinguish
between
bone
and
bone
marrow
to
determine
bone
volume
fraction.
Correlations
between
the
amount
of
bone
and
Young's
modulus,
yield
stress,
and
ultimate
stress
have
been
determined
using
MR
and
several
other
clinical
and
experimental
imaging
modalities.
Along
with
the
amount
of
bone,
it
has
been
reported
that
trabecular
b
o
n
e
o
r
i
e
n
t
a
t
i
o
n
a
n
d
s
t
r
u
c
t
u
r
e
c
o
n
t
r
i
b
u
t
e
t
o
b
o
n
e
s
t
r
e
n
g
t
h
b
a
s
e
d
o
n
[
8
]
.
C.
Bone
Characterization
using
Piezotransducers
as
Biomedical
Sensors
This
technical
note
explores
the
possibility
of
miniaturized
piezoelectric
ceramic
transducers
(PZT)
patches
as
biomedical
sensors
to
evaluate
the
structural
dynamic
characteristics
of
bones,
by
employing
them
as
transmitters
and
receptors
of
acoustic
waves.
The
results
show
that
theoretical
computations
are
not
very
reliable
for
bone-like
materials,
but
the
results,
in
general,
are
enough
to
warrant
more
study
as
a
method
of
detecting
imperfections
such
as
bone
porosity
rather
than
structural
characteristics
according
to
[9].
D.
Nanomechanical
characterization
of
tissue-engineered
on
bone
grown
on
titanium
alloy
in
vitro
In
this
study,
the
bone-like
mineralized
matrix
was
produced
by
osteoblasts
cultured
in
vitro
on
the
surface
of
titanium
alloys.
The
volume
of
this
tissue-engineered
bone
is
so
small
that
the
conventional
tensile
tests
or
bending
tests
are
implausible.
Therefore,
nanoindentation
techniques
that
allow
the
characterization
of
the
test
material
from
the
nanoscale
to
the
microscale
were
adopted.
These
reveal
the
apparent
elastic
modulus
and
hardness
of
the
calcospherulite
crystals
(a
representative
element
for
woven
bone).
Nanoindentation
with
in
situ
atomic
force
microscope
(AFM)
imaging
is
very
useful
to
identify
and
characterize
the
small
features
in
the
bone
which
is
not
easily
achievable
by
other
techniques.
The
surface
topography
of
sub-regions,
heterogeneous
microstructure,
anisotropy
(local
grain
orientation),
and
inhomogeneous
composition
lead
to
a
statistical
distribution
of
the
measured
Young’s
modulus
and
hardness.
The
average
value
of
Young’s
modulus
is
consistent
with
what
is
expected
for
woven
bone
in
a
rat.
The
hardness
values
are
also
reasonable
for
this
type
of
bone.
Dynamic
mechanical
analysis
during
nanoindentation
can
determine
the
viscoelastic
properties
of
this
tissue-engineered
bone
as
indicated
in
[10].
18
Vélez-Cruz & Fariñas-Coronado.
Review-Bone Characterization: Mechanical Properties Based on Non-Destructive Techniques
ISSN-E:
2737-6439
Athenea
Journal
Vol.3,
Núm.
10,
(pp.
16-29)
F.
The
Mechanical
Properties
of
Bone
Comparison
of
the
maximum
compressive
stress
and
modulus
of
elasticity
of
the
rectangular
and
cubic
s
p
e
c
i
m
e
n
s
a
c
c
o
r
d
i
n
g
t
o
t
h
e
d
i
r
e
c
t
i
o
n
o
f
l
o
a
d
i
n
g
s
h
o
w
e
d
t
h
a
t
s
p
o
n
g
y
b
o
n
e
i
s
a
n
a
n
i
s
o
t
r
o
p
i
c
m
a
t
e
r
i
a
l
,
i
.
e
.
,
a
material
that
is
not
equally
strong
in
all
directions.
Another
mechanical
property
of
bone
to
be
considered
is
its
f
a
t
i
g
u
e
l
i
f
e
.
T
h
i
s
i
s
e
s
p
e
c
i
a
l
l
y
i
m
p
o
r
t
a
n
t
a
b
o
u
t
m
a
r
c
h
,
s
t
r
e
s
s
,
o
r
f
a
t
i
g
u
e
f
r
a
c
t
u
r
e
s
d
e
b
a
t
e
d
i
n
[
1
1
]
.
G.
Biomechanical
Characteristics
of
the
Bone
A
hard
material
will
respond
with
a
minimum
deformation
to
the
load
increase.
When
the
material
fails
at
the
end
of
the
elastic
phase,
it
is
considered
a
fragile
material.
Glass
is
an
example
of
a
fragile
material.
The
bone
is
not
so
hard
as
glass
or
metal,
and
the
difference
between
the
materials
is
that
it
does
not
respond
linearly,
b
e
c
a
u
s
e
i
t
c
e
d
e
s
a
n
d
d
e
f
o
r
m
s
,
b
u
t
n
o
t
u
n
i
f
o
r
m
l
y
d
u
r
i
n
g
t
h
e
l
o
a
d
p
l
a
c
e
m
e
n
t
p
h
a
s
e
.
T
h
e
h
i
g
h
e
r
t
h
e
l
o
a
d
imposed
on
the
bone,
the
higher
the
deformation.
In
addition,
if
the
load
exceeds
the
elastic
limits
of
the
material,
there
will
be
a
permanent
deformation
and
failure
of
the
material.
If
a
material
continues
to
over-
elongate
and
over-deform
in
the
plastic
phase,
it
is
known
as
a
flexible
material.
The
skin
is
an
example
of
a
material
that
is
deformed
considerably
before
the
failure.
Bone
is
a
material
that
has
properties
that
respond
in
both
the
fragile
and
the
flexible
mode
as
reported
in
[12].
This
article
indicates
that
the
hardness
of
the
b
o
n
e
i
s
a
g
o
o
d
i
n
d
i
c
a
t
o
r
o
f
i
t
s
m
e
c
h
a
n
i
c
a
l
p
r
o
p
e
r
t
i
e
s
.
I
t
a
l
s
o
s
u
g
g
e
s
t
s
p
o
r
o
s
i
t
y
a
s
a
f
f
e
c
t
i
n
g
t
h
e
h
a
r
d
n
e
s
s
o
f
bone,
as
materials
science
tells
us
does
with
other
materials.
H.
Bone
Mechanics
The
field
of
bone
mechanics
has
evolved
to
a
very
sophisticated
level,
in
which
the
mechanical
properties
of
cortical
and
trabecular
bone
are
available
for
many
anatomic
sites.
Studies
have
reported
on
the
effects
of
bone
density,
aging,
and
disease
on
these
properties,
enabling
researchers
to
perform
highly
detailed
specimen-specific
analyses
on
whole
bone
and
bone-implant
systems
mentioned
in
[13].
This
article
suggests
that
current
methods
of
measuring
porosity
(really
bone
density)
would
be
useful
in
determining
an
individual’s
bone
mechanical
properties
against
a
standardized
set
of
data.
I.
The
Material
Properties
of
Human
Tibia
Cortical
Bone
in
Tension
and
Compression:
Implications
for
the
Tibia
Index
The
properties
of
bone
are
subjected
to
a
more
precise
standard
of
measurement
and
the
difference
in
precision
is
found
to
have
yielded
no
statistically
significant
difference
from
other
less
precise
experiments
established
in
[14].
From
this
we
take
that
observation
from
a
patient
can
be
interpreted
from
a
less
invasive
test
with
comparable
results
to
the
most
invasive
test
of
all,
dissection,
and
preparation
for
a
stress-strain
test.
J.
Noninvasive
Measurements
of
Bone
Mass,
Structure,
and
Strength:
Current
Methods
and
Experimental
Techniques
The
article
presents
different
types
of
radiological
procedures
that
would
allow
for
non-invasive
measurement
of
bones
that
are
evaluated
to
be
very
promising
and
in
need
of
validation.
Based
on
[15],
the
noninvasive
technics
used
for
assessing
bone
content
and
density
are
dual-photon
absorptiometry
single-photon
absorptiometry,
dual-energy
X-ray
absorptiometry,
and
quantitative
computed
tomography
(QCT)
while
distinguishing
between
patients
with
and
without
osteoporosis.
Extensions
of
conventional
densitometry
have
been
developed
by
several
researchers
to
include
information
related
to
bone
mass
also
are
presented.
Preliminary
studies
show
the
values
of
these
new
techniques
in
the
noninvasive
measurement
of
bone
structure
to
estimate
the
bone
strength
and
assess
fracture
risk
more
accurately.
19
Vélez-Cruz & Fariñas-Coronado.
Review-Bone Characterization: Mechanical Properties Based on Non-Destructive Techniques
ISSN-E:
2737-6439
Athenea
Journal
V
o
l
.
3
,
N
ú
m
.
1
0
,
(
p
p
.
1
6
-
2
9
)
K.
Measurement
of
abnormal
bone
composition
in
vivo
using
noninvasive
Raman
spectroscopy
X-ray-based
diagnostic
techniques
are
by
far
the
most
widely
used
for
diagnosing
bone
disorders
and
diseases,
which
are
largely
blind
to
the
protein
component
of
bone.
Bone
proteins
are
important
because
they
determine
certain
mechanical
properties
of
bone
and
changes
in
the
proteins
have
been
associated
with
several
bone
diseases
explained
in
[16].
Spatially
Offset
Raman
Spectroscopy
(SORS)
is
a
chemically
specific
analytical
technique
that
can
be
used
to
retrieve
information
noninvasively
from
both
the
mineral
and
protein
phases
of
the
bone
material
in
vivo.
T
h
e
p
r
o
t
e
i
n
c
o
m
p
o
s
i
t
i
o
n
o
f
b
o
n
e
i
s
a
n
i
n
d
i
c
a
t
o
r
o
f
p
o
r
o
s
i
t
y
t
h
u
s
i
t
c
o
u
l
d
b
e
l
i
n
k
e
d
t
o
t
h
e
s
t
r
e
n
g
t
h
o
f
t
h
e
material
if
compared
to
an
established
set
of
data.
L.
Osseointegration:
An
Update
Osseointegration
is
a
complex
process
between
an
implant
and
the
bone
surrounding
it
that
can
be
influenced
by
many
factors
relating
to
the
surface
topography,
biocompatibility,
and
loading
conditions
all
play
an
important
role
in
osseointegration.
The
quality
of
osseointegration
is
tied
to
the
porosity
of
the
bone
and
the
ability
of
the
implant
to
exchange
active
ion
sites
with
the
bone.
Titanium
and
its
alloys
are
the
materials
of
choice
clinically,
because
of
their
excellent
biocompatibility
and
superior
mechanical
properties
as
indicated
in
[17].
The
combined
effect
of
surface
energy,
surface
roughness,
and
topography
on
the
implant
determines
its
ultimate
ability
to
integrate
into
the
surrounding
tissue.
Surface
modification
technologies
involve
preparation
with
either
an
additive
coating
or
a
subtractive
method.
Cell
migration,
adhesion,
and
proliferation
on
implant
surfaces
are
important
prerequisites
to
initiate
the
process
of
tissue
regeneration,
while
modifications
of
the
i
m
p
l
a
n
t
s
u
r
f
a
c
e
b
y
i
n
c
o
r
p
o
r
a
t
i
o
n
o
f
b
i
o
l
o
g
i
c
m
e
d
i
a
t
o
r
s
o
f
g
r
o
w
t
h
a
n
d
d
i
f
f
e
r
e
n
t
i
a
t
i
o
n
m
a
y
b
e
p
o
t
e
n
t
i
a
l
l
y
b
e
n
e
f
i
c
i
a
l
i
n
e
n
h
a
n
c
i
n
g
w
o
u
n
d
h
e
a
l
i
n
g
f
o
l
l
o
w
i
n
g
i
m
p
l
a
n
t
p
l
a
c
e
m
e
n
t
.
M.
Contact
problems
with
friction,
adhesion,
and
wear
in
orthopaedic
biomechanics.
I:
General
developments
The
bone-implant
interface
behavior
is
far
from
being
fully
recognized
and
understood;
also,
one
lacks
reliable
phenomenological
models
as
it
was
mentioned
in
[18].
Along
with
mentioning
the
various
problems
with
joint
and
bone
implants,
this
article
mentions
the
lack
of
models
that
can
predict
the
behavior
of
implants.
N.
Spine
Interbody
Implants:
Material
Selection
and
Modification,
Functionalization
and
Bioactivation
of
Surfaces
to
Improve
Osseointegration
Achieving
bone
integration
with
an
interbody
implant
is
likely
to
aid
fusion
and
improve
implant
longevity
by
limiting
subsidence
and
stress
shielding
and
associated
complications.
Surface
modification
and/or
conversion
of
implant
surfaces
into
bioactive
areas
is
intended
to
improve
in-growth
and
on-growth
were
discussed
in
[19].
Along
with
mentioning
the
various
problems
with
joint
and
bone
implants,
this
article
underlines
the
lack
of
models
that
can
predict
the
behavior
of
implants.
O.
Dynamic
bone
quality-a
non-invasive
measure
of
bone's
biomechanical
property
Using
dual
x-ray
absorptiometry
(DXA),
bone
mineral
density
(BMD)
is
usually
measured
to
detect
osteoporosis.
Combing
this
test
with
a
damping
factor
test
is
indicative
of
fractures
in
one
of
several
places
as
shown
in
[20].
This
is
useful
because
it
indicates
a
factor
that
can
be
accounted
for,
and
modeled
for,
reducing
prosthetic
failure
by
upping
the
damping
factor
of
the
material.
The
idea
that
complementing
the
prosthetic
in
other
places
of
the
body
is
also
interesting
and
makes
sense
given
that
having
a
stronger
material
in
one
place
might
create
a
different
failure
point.
20
Vélez-Cruz & Fariñas-Coronado.
Review-Bone Characterization: Mechanical Properties Based on Non-Destructive Techniques
ISSN-E:
2737-6439
Athenea
Journal
Vol.3,
Núm.
10,
(pp.
16-29)
P.
Bone
biology,
osseointegration,
and
bone
grafting
The
structural
integrity
of
bone
may
be
compromised
in
times
of
normal
metabolic
calcium
need
and
in
disease
states,
thus
altering
bone
structure
and
mass.
This
phenomenon
can
be
noted
in
the
bone
structure
of
postmenopausal
women,
who
experience
a
decrease
in
estrogen
hormones.
As
bone
mass
is
lost,
the
interconnections
between
bone
trabeculae
also
are
lost.
Because
normal
interconnections
play
an
important
role
in
making
bone
a
biomechanically
rigid
structure,
this
decrease
leads
to
fragility
and
failure
of
the
bone
structure
presented
in
[21].
It
is
important
to
note
that
gender
plays
a
role
in
the
structure,
since
the
absorption
rate
of
calcium
is
different
between
men
and
women,
and
it
is
suggested
that
it
is
even
different
b
e
t
w
e
e
n
r
a
c
e
s
/
e
t
h
n
i
c
i
t
i
e
s
.
Q
u
a
n
t
i
f
y
i
n
g
t
h
e
s
e
d
i
f
f
e
r
e
n
c
e
s
i
s
i
m
p
o
r
t
a
n
t
f
o
r
t
h
e
m
o
d
e
l
t
o
w
o
r
k
.
Q
.
M
e
t
h
o
d
s
f
o
r
a
s
s
e
s
s
i
n
g
b
o
n
e
q
u
a
l
i
t
y
Methods
for
characterizing
bone
geometry
and
microarchitecture
include
quantitative
CT,
high-resolution
peripheral
quantitative
CT,
high-resolution
MRI,
and
micro-CT.
Outcomes
include
three-dimensional
whole-
bone
geometry,
trabecular
morphology,
and
tissue
mineral
density.
The
primary
advantage
is
the
ability
to
image
non-invasively;
disadvantages
include
the
lack
of
a
direct
measure
of
bone
strength.
Methods
for
measuring
tissue
composition
include
scanning
electron
microscopy,
vibrational
spectroscopy,
nuclear
magnetic
resonance
imaging,
and
chemical
and
physical
analytical
techniques.
Outcomes
include
mineral
density
and
crystallinity,
elemental
composition,
and
collagen
crosslink
composition.
Advantages
include
the
detailed
material
characterization;
disadvantages
include
the
need
for
a
biopsy
as
discussed
in
[22].
The
article
concludes
that
although
no
single
method
can
completely
characterize
bone
quality,
current
n
o
n
i
n
v
a
s
i
v
e
i
m
a
g
i
n
g
t
e
c
h
n
i
q
u
e
s
c
a
n
b
e
c
o
m
b
i
n
e
d
w
i
t
h
e
x
-
v
i
v
o
m
e
c
h
a
n
i
c
a
l
a
n
d
c
o
m
p
o
s
i
t
i
o
n
a
l
t
e
c
h
n
i
q
u
e
s
t
o
p
r
o
v
i
d
e
a
c
o
m
p
r
e
h
e
n
s
i
v
e
u
n
d
e
r
s
t
a
n
d
i
n
g
o
f
b
o
n
e
q
u
a
l
i
t
y
.
R.
Biomechanical
background
for
a
noninvasive
assessment
of
bone
strength
and
muscle-bone
interactions
Bones
would
not
control
their
mass
in
order
to
optimize
their
strength.
They
would
rather
control
their
architecture
to
optimize
their
structural
stiffness.
No
solid
structure
fails
without
undergoing
some
tensile
strain
at
some
point.
Therefore,
the
chief
skeletal
property
concerning
body-weight
bearing
is
stiffness
(i.e.,
the
relationship
between
the
load
on
a
bone
and
its
deformation).
A
rigid
material
(mineralized
collagen)
seems
to
have
developed
during
evolution
for
building
bones.
However,
the
mechanical
efficiency
of
bones
seemed
not
to
depend
on
the
mere
accumulation
of
material
but
rather
on
the
optimization
of
its
spatial
distribution
demonstrated
in
[23].
This
contrasts
with
other
articles
mentioned
here,
which
list
the
rate
of
absorption
for
minerals
as
a
linear
property
without
regard
to
its
spatial
distribution.
S.
Biomechanical
consideration
in
osseointegrated
support
protheses
Biomechanics
are
of
two
types:
Reactive
and
Therapeutic.
Reactive
biomechanics
refers
to
the
interaction
of
isolated
biomechanical
factors
which
when
combined,
produce
an
accumulative
effect
and
therapeutic
refers
to
the
clinical
process
of
altering
each
biomechanical
factor
to
reduce
the
cumulative
response
causing
implant
overload
and
failure
as
revealed
in
[24].
Biomechanical
failures
do
occur
due
to
deficient
knowledge
of
the
forces
the
implant
would
be
subjected
to.
Hence
it
is
always
necessary
for
the
team
professionals
to
have
a
thorough
knowledge
of
the
basic
principles
of
biomechanics
and
plan
the
treatment
accordingly.
This
reinforces
the
need
to
pre-plan
and
therapeutically
alter
the
biomechanics
to
help
osseointegration.
21
Vélez-Cruz & Fariñas-Coronado.
Review-Bone Characterization: Mechanical Properties Based on Non-Destructive Techniques
ISSN-E:
2737-6439
Athenea
Journal
Vol.3,
Núm.
10,
(pp.
16-29)
T.
Muscle
Strength
and
Bone
Mineral
Density
in
mine
victims
with
transtibial
amputation
L
o
c
a
l
m
u
s
c
l
e
s
t
r
e
n
g
t
h
a
n
d
m
u
s
c
l
e
c
o
n
t
r
a
c
t
i
o
n
s
a
r
e
i
m
p
o
r
t
a
n
t
f
a
c
t
o
r
s
f
o
r
l
o
c
a
l
b
o
n
e
m
i
n
e
r
a
l
d
e
n
s
i
t
y
a
n
d
t
h
e
s
e
factors
need
to
be
paid
more
attention
to
in
amputee
patients.
Bone
mineral
density
and
muscle
strength
are
l
o
w
e
r
o
n
t
h
e
a
m
p
u
t
a
t
e
d
s
i
d
e
t
h
a
n
o
n
t
h
e
s
o
u
n
d
s
i
d
e
a
n
d
l
o
c
a
l
b
o
n
e
l
o
s
s
i
s
r
e
l
a
t
e
d
t
o
t
h
e
l
o
s
s
o
f
m
u
s
c
l
e
strength
in
transtibial
amputees
shown
in
[25].
This
article
is
important
because
it
highlights
the
need
to
account
for
the
muscle
density
of
the
patient.
U.
Revolutionizing
Prosthetics:
Extreme
Trans-disciplinary
Systems
Engineering
An
overview
of
a
Defense
Advanced
Research
Projects
Agency
(DARPA)
project
that
created
an
advanced
upper-limb
prosthetics.
They
importantly
concluded
that
when
it
comes
to
choosing
to
implement
such
a
procedure
on
a
person,
that
one
size
(or
in
this
case
prosthetic)
does
not
fit
all
and
that
it
must
be
tailored
to
use,
biology,
cost,
and
expectations.
Each
approach
had
risks
and
rewards,
and
ultimately
the
choice
should
be
made
by
the
patient
and
his/her
clinician.
As
a
result,
a
multimodal
neural
integration
framework
should
be
designed
to
use
one
or
more
approaches
in
synergy
with
each
other
as
discussed
in
[26].
V
.
N
o
n
i
n
v
a
s
i
v
e
i
m
a
g
i
n
g
o
f
b
o
n
e
m
i
c
r
o
a
r
c
h
i
t
e
c
t
u
r
e
High-resolution
peripheral
quantitative
computed
tomography
(HR-pQCT)
imaging
requires
a
dedicated
extremity
scanner.
Using
HR-pQCT,
measures
of
three-dimensional
(3D)
bone
geometry,
overall
and
compartment-specific
bone
density,
and
bone
microarchitecture
can
be
acquired
within
a
scan
time
of
3
minutes.
Cross-sectional
HR-pQCT
studies
have
also
provided
insight
into
the
age,
race,
and
gender-specific
aspects
of
bone
quality.
Asian
men
and
women
have
smaller
bones;
thus
BMD,
as
measured
by
DXA,
tends
to
underestimate
their
real
bone
density.
Nevertheless,
Asians
sustain
fewer
fractures.
Using
HR-pQCT,
it
was
found
that
despite
the
relatively
low
total
bone
area,
premenopausal
Asian
women
displayed
significantly
thicker
cortices
and
a
richer
trabecular
microarchitecture
than
Caucasians.
The
finite
elements
(FE)
analyses
yielded
higher
estimates
of
bone
stiffness/strength.
Menopause
diminishes
some
of
these
microstructural
advantages,
but
significant
racial
differences
remain
detectable
according
to
[27].
This
study
solidifies
HR-pQCT
as
a
good
candidate
for
use
in
procedure
since
it
yields
the
most
information
from
one
test,
and
it
furthers
the
idea
introduced
by
[21]
that
race
plays
a
role
in
bone
density.
W.
Noninvasive
evaluation
of
bone
micro-architecture
and
strength
Noninvasive
imaging
techniques,
including
quantitative
computed
tomography
(QCT),
high-resolution
peripheral
QCT
(HR-pQCT),
and
magnetic
resonance
imaging
(MRI)
allow
for
the
assessment
of
bone
microarchitecture
and
strength,
which
are
thought
to
underlie
fracture
risk.
The
researcher
concentrated
on
the
potential
clinical
utility
of
these
techniques
to
enhance
understanding
of
the
skeletal
changes
that
occur
during
growth
and
aging,
differences
between
male
and
female
skeletons,
the
assessment
of
the
response
to
drug
therapies,
and
the
identification
of
patients
at
risk
of
fracture.
At
least
in
those
first
three
areas,
the
new
imaging
systems
appear
poised
to
serve
as
invaluable
research
tools
that
ultimately
may
offer
an
understanding
of
fracture
mechanisms
far
beyond
what
DXA
can
provide.
However,
they
are
unlikely
to
supplant
DXA
any
time
soon
in
the
realm
of
fracture
risk
prediction.
This
is
because
‘While
more
work
is
needed
looking
at
other
sites,
like
the
spine,
in
general,
these
biomechanical
findings
fit
with
the
growing
epidemiological
data
suggesting
that
DXA
works
regardless
of
gender,
in
part
because
it’s
so
influenced
by
bone
size
as
shown
in
[28].
There
is
also
the
consideration
that
these
other
imaging
tools
are
much
more
specialized
and
finicky
to
research
with,
as
the
same
machine
must
be
used
through
the
whole
process
and
the
setup
must
be
the
same
every
time,
a
detail
that
according
to
the
author’s
opinion
is
enough
to
discard
them
entirely.
22
Vélez-Cruz & Fariñas-Coronado.
Review-Bone Characterization: Mechanical Properties Based on Non-Destructive Techniques
ISSN-E:
2737-6439
Athenea
Journal
Vol.3,
Núm.
10,
(pp.
16-29)
X
.
O
s
s
e
o
i
n
t
e
g
r
a
t
i
o
n
a
m
p
u
t
a
t
i
o
n
p
r
o
s
t
h
e
s
e
s
o
n
t
h
e
u
p
p
e
r
l
i
m
b
s
:
m
e
t
h
o
d
s
,
p
r
o
s
t
h
e
t
i
c
s
,
a
n
d
r
e
h
a
b
i
l
i
t
a
t
i
o
n
T
r
a
d
i
t
i
o
n
a
l
p
r
o
s
t
h
e
t
i
c
s
o
c
k
e
t
a
n
d
s
u
s
p
e
n
s
i
o
n
t
e
c
h
n
o
l
o
g
y
o
f
t
e
n
f
a
i
l
t
o
m
e
e
t
b
o
t
h
c
o
s
m
e
t
i
c
a
n
d
f
u
n
c
t
i
o
n
a
l
requirements,
which
can
severely
impair
quality
of
life.
With
direct
bone
anchorage,
the
prosthesis
is
attached
to
the
residual
limb
without
the
use
of
a
socket.
The
method
is
based
on
the
principle
of
osseointegration,
which
has
been
in
clinical
use
for
tooth
and
maxillofacial
replacements
since
1965
as
described
by
[3].
23
F
ig.
1.
Implant
System-The
implant
system
incorporates
three
main
components:
a
threaded
titanium
implant
(the
fixture),
a
skin-penetrating
cylindrical
implant
(the
abutment),
and
a
titanium
screw
(the
abutment
screw)
which
holds
the
system
together
[29].
This
article
gives
a
good
overview
of
osseointegration
and
gives
suggestive
data
about
possible
problems
with
implementation,
but
the
big
takeaway
here
is
that
careful
consideration
of
implementation
yields
the
best
results.
Y.
Skeletal
Scintigraphy
(Bone
Scan)
M
e
a
s
u
r
e
s
b
o
n
e
e
l
a
s
t
i
c
i
t
y
,
t
h
e
s
t
r
u
c
t
u
r
e
o
f
t
r
a
b
e
c
u
l
a
r
,
a
n
d
a
p
p
a
r
e
n
t
d
e
n
s
i
t
y
.
T
h
e
c
o
m
m
o
n
s
i
t
e
o
f
m
e
a
s
u
r
e
m
e
n
t
i
s
t
h
e
non-dominant
calcaneus,
which
a
laterally
projecting
piezoelectric
transducer
transmits
US
energy
toward
a
receiving
transducer.
The
material
determines
the
velocity
and
degree
of
penetration
of
the
sound
waves.
Greater
penetration
(less
attenuation)
and
lower
velocity
are
possible
with
more
porous
bone
(slower
wave).
The
calcaneus
has
several
advantages
as
a
QUS
measurement
site:
it
can
be
viewed
via
two
almost
plane-parallel
surfaces;
it
is
primarily
made
up
of
trabecular
bone,
which
is
more
metabolically
active
than
cortical
bone;
the
soft
tissue
above
it
is
thin,
and
it
is
a
weight-bearing
bone.
The
broadband
ultrasonic
attenuation
(BUA,
m/s),
ultrasound
velocity
(speed
of
sound—SOS,
dB/MHz),
and
a
computed
stiffness
index
based
on
the
product
of
BUA
and
SOS
modified
by
three
distinct
constants
are
commonly
used
to
measure
composite
bone
qualities
as
indicated
in
[30].
QUS
devices
are
small,
portable,
and
relatively
inexpensive
and
operator
training.
Can
be
performed
quickly
and
without
exposure
to
ionizing
radiation.
Z.
Resonant
Ultrasound
Spectroscopy:
theory
and
application
In
various
musculoskeletal
diseases
and
diagnostic
orthopedic
medicine,
bone
scintigraphy
is
one
of
the
most
utilized
diagnostic
procedures
to
study
bone
lesions
and
metastases.
Later
advancements,
such
as
single-photon
emission
computed
tomography
(SPECT)
and
positron
emission
tomography
(PET),
have
made
it
possible
to
acquire
whole-
body
scans
of
the
whole
skeleton.
They
improve
lesion
detection
sensitivity
and,
more
critically,
allow
for
3D
localization
of
radiation
generated
by
radionuclide
imaging
agents
or
biomarkers,
with
detection
sensitivity
down
to
nano-
or
picomolar
concentrations.
The
expansion
of
clinical
nuclear
imaging
applications
has
resulted
in
the
creation
of
a
dedicated
small
animal
imaging
system
presented
in
[31].
In
osteoarthritis,
alterations
in
bone
turnover
and
cartilage
composition
can
be
detected.
Micro-SPECT/micro-CT
co-imaging
can
detect
high
uptake
of
Tc-99
m
MDP,
imaging
areas
with
high
bone
turnover,
such
as
joints
(knees,
shoulders),
spine,
and
skull.
Vélez-Cruz & Fariñas-Coronado.
Review-Bone Characterization: Mechanical Properties Based on Non-Destructive Techniques
ISSN-E:
2737-6439
Athenea
Journal
V
o
l
.
3
,
N
ú
m
.
1
0
,
(
p
p
.
1
6
-
2
9
)
A
A
.
R
e
s
o
n
a
n
t
U
l
t
r
a
s
o
u
n
d
S
p
e
c
t
r
o
s
c
o
p
y
R
e
s
o
n
a
n
t
U
l
t
r
a
s
o
u
n
d
S
p
e
c
t
r
o
s
c
o
p
y
(
R
U
S
)
i
s
a
n
e
l
e
g
a
n
t
s
t
r
a
t
e
g
y
f
o
r
m
e
a
s
u
r
i
n
g
t
h
e
t
o
t
a
l
e
l
a
s
t
i
c
t
e
n
s
o
r
o
f
a
fabric.
The
scheme
utilizes
the
reality
that
the
mechanical
vibration
resonance
range
depends
on
the
geometry,
mass
density,
and
elastic
tensor
of
the
test.
RUS
to
utilize
these
conditions
to
gather
flexible
properties
or
shape
parameters
of
tests
from
a
suite
of
measured
resonance
frequencies
as
demonstrated
by
[32].
To
perform
a
reversal,
we
must
have
a
way
of
anticipating
these
frequencies
for
an
arbitrary
elastic
body.
Normal
modes
of
elastic
substances
are
used
in
Resonant
Ultrasound
Spectroscopy
(RUS)
to
determine
material
properties
such
as
elastic
moduli.
In
theory,
a
single
measurement
could
be
used
to
infer
the
entire
elastic
tensor.
RUS
bridges
the
experimental
gap
between
low-frequency
stress-strain
methods
(quasi-static
up
to
a
few
kHz)
and
ultrasonic
time-delay
methods
for
centimeter-sized
samples
(hundreds
of
kHz
to
GHz).
BB.
Imaging-Based
Methods
for
Non-invasive
Assessment
of
Bone
Properties
Influenced
by
Mechanical
Loading
Skeletal
scintigraphy
makes
a
difference
to
diagnose
and
evaluate
an
assortment
of
bone
diseases
and
c
o
n
d
i
t
i
o
n
s
u
t
i
l
i
z
i
n
g
l
i
t
t
l
e
s
u
m
s
o
f
r
a
d
i
o
a
c
t
i
v
e
m
a
t
e
r
i
a
l
s
c
a
l
l
e
d
r
a
d
i
o
t
r
a
c
e
r
s
t
h
a
t
a
r
e
i
n
f
u
s
e
d
i
n
t
o
t
h
e
c
i
r
c
u
l
a
t
i
o
n
system.
The
radiotracer
voyages
through
the
zone
being
inspected
and
gives
off
radiation
within
the
shape
of
gamma
beams
which
are
identified
by
an
uncommon
gamma
camera
and
a
computer
to
form
pictures
of
your
bones
as
mentioned
in
[33].
Since
it
can
pinpoint
atomic
movement
inside
the
body,
skeletal
scintigraphy
offers
the
potential
to
recognize
illness
in
its
most
punctual
stages.
The
common
uses
of
the
bone
scan
are
to
help
determine
the
location
of
an
abnormal
bone
in
complex
bone
structures,
such
as
the
foot
or
spine.
diagnose
broken
bones,
such
as
a
stress
fracture
or
a
hip
fracture,
not
clearly
seen
on
x-rays,
and
find
bone
damage
caused
by
infection
or
other
conditions.
CC.
Imaging
Technologies
for
Preclinical
Models
of
Bone
and
Joint
Disorders
Investigative
devices
are
being
created
to
build
computer-based
3D
geometric
models
of
bone
inferred
from
serial
transaxial
whole-body
QCT,
HR-pQCT,
and
HR-MRI
imaging
utilizing
FEA.
Whole-body
QCT
pictures
are
post-processed
utilizing
a
commercially
accessible
program
to
create
1
to
3
mm
bone
voxels,
which
are
changed
over
into
similarly
measured
“finite
elements”—each
relegated
homogeneous
fabric
flexible
properties
agent
of
human
cortical
or
trabecular
bone
as
explained
in
[34].
Additionally,
µFEA
models
can
be
built
from
HR-pQCT
and
HR-MRI
filters
of
peripheral
skeletal
sites
at
an
indeed
higher
ostensible
determination
to
supplying
a
point-by-point
representation
of
the
microstructure.
“Virtual”
loads
(i.e.,
to
recreate
powers
related
with
compression,
bowing,
single-leg
position,
or
sideways
drop)
are
connected
to
a
volumetric
locale
intrigued
to
foresee
fabric
properties
such
as
flexible
modulus,
stresses,
disappointment
stack,
and
rate
of
stack
carried
by
distinctive
bone
locales.
III.
METHODOLOGY
During
this
review,
which
is
related
to
obtaining
mechanical
properties
from
non-invasive
techniques,
the
focus
of
this
literature
review
was
carried
out
taking
into
consideration
scientific
articles
and
theses,
publications
in
physical
and
digital
format
and
presentations
at
conferences
provided
by
authors,
librarians,
and
scientific
entities.
In
addition,
American
and
European
databases
were
searched,
including
the
repositories
of
academic
institutions
specialized
in
the
field
of
biomedical
engineering.
Finally,
a
little
information
was
obtained
from
sources
such
as
engineering
textbooks,
technical
manuals,
medicine
and
engineering
handbooks,
the
internet,
and
review
articles.
24
Vélez-Cruz & Fariñas-Coronado.
Review-Bone Characterization: Mechanical Properties Based on Non-Destructive Techniques
ISSN-E:
2737-6439
Athenea
Journal
V
o
l
.
3
,
N
ú
m
.
1
0
,
(
p
p
.
1
6
-
2
9
)
The
keywords
used
within
the
revision
of
this
article
were
as
follows:
·“Mechanical
Properties”
and
“Non-Invasive
Techniques”
·“Stress-Strain
Relationship”
and
“Non-Destructive
Techniques”
·“Bone
Characterization”
and
“Bone
Diagnosis”
·“Young
Modulus”
and
“Cortical
Bone”
·“Mechanical
properties
correlation”
and
“Images”
·“Bone
Mineral
Content
(BMC)
Evaluation”
and
“Bone
Mineral
Density
(BMD)
Evaluation”
IV. RESULTS
Table
2.
Most
Relevant
Papers
to
Obtain
Mechanical
Properties
Based
on
Non-Invasive
Techniques.
ISSN-E:
2737-6439
Athenea
Journal
V
o
l
.
3
,
N
ú
m
.
1
0
,
(
p
p
.
1
6
-
2
9
)
O
r
i
g
i
n
a
l
l
y
,
a
n
e
x
h
a
u
s
t
i
v
e
s
e
a
r
c
h
w
a
s
c
a
r
r
i
e
d
o
u
t
i
n
t
h
e
m
a
i
n
d
a
t
a
b
a
s
e
o
f
t
h
e
P
o
l
y
t
e
c
h
n
i
c
U
n
i
v
e
r
s
i
t
y
o
f
P
u
e
r
t
o
Rico,
obtaining
fifty-five
(55)
articles
related
to
the
topic
above,
filtering
the
publication
periods
from
ranges
b
e
t
w
e
e
n
2
0
0
0
t
o
2
0
2
2
.
A
m
o
n
g
t
h
e
m
o
s
t
c
o
m
m
o
n
s
e
a
r
c
h
a
n
d
d
a
t
a
b
a
s
e
s
u
s
e
d
f
o
r
t
h
i
s
r
e
v
i
e
w
a
r
e
"
P
u
b
M
e
d
"
,
"Scopus",
"IEEE",
"EBSCO",
"Google
Scholar"
and
"Science
Direct",
among
others.
However,
only
thirty-five
(35)
articles
were
selected
since
they
showed
a
strong
correlation
with
the
main
purpose
of
the
review.
The
twenty
(20)
rejected
articles
were
evaluated
to
determine
which
of
these
would
meet
the
inclusion
or
exclusion
criteria.
For
each
criterion,
several
elements
were
created
that
helped
either
to
accept
or
reject
the
articles
to
be
included
in
this
review,
including
the
technical
knowledge
and
characteristics
of
the
intended
topic
(See
table
1
below).
Table
1.
Inclusion
and
Exclusion
Criteria
25
Vélez-Cruz & Fariñas-Coronado.
Review-Bone Characterization: Mechanical Properties Based on Non-Destructive Techniques
I
S
S
N
-
E
:
2
7
3
7
-
6
4
3
9
Athenea
Journal
Vol.3,
Núm.
10,
(pp.
16-29)
26
CONCLUSIONS
It
has
been
noticed
that
exists
a
gap
of
knowledge
regarding
the
non-invasive
evaluation
of
bones
to
determine
their
mechanical
properties.
There
is
a
lack
of
non-invasive
standards
and
their
associated
availability
in
the
market,
which
makes
difficult
the
evaluation
concerns
prosthetic
and
medical
device
fitting.
Also,
it
can
be
concluded
that
non-invasive
techniques
are
extremely
useful
when
evaluations
of
bone
diseases
are
needed.
The
bone
diseases
such
as
osteogenesis
imperfecta,
osteoporosis,
and
micro-fractures
can
be
predicted
in
advance
with
these
types
of
non-invasive
techniques.
Based
on
the
above
review,
one
of
the
most
Vélez-Cruz & Fariñas-Coronado.
Review-Bone Characterization: Mechanical Properties Based on Non-Destructive Techniques
27
promising
non-invasive
techniques
is
the
one
related
to
the
evaluation
of
the
porosity
of
bone,
which
shows
a
significant
connection
with
medical
practices
and
their
current
challenges.
Even
this
practice
is
in
dispute,
for
example,
[23]
suggests
that
the
rate
of
absorption
and
accumulation
of
minerals
is
not
a
linear
relationship
but
that
it
does
accumulate
in
a
pattern
that
suggests
that
the
body
accumulates
favoring
stiffness
rather
than
strength
or
flexibility.
This
is
in
contrast
with
most
other
relevant
articles
listed
here
that
state
that
a
c
c
u
m
u
l
a
t
i
o
n
l
e
a
d
s
t
o
h
a
r
d
n
e
s
s
a
n
d
a
b
s
e
n
t
t
h
a
t
,
o
s
t
e
o
p
e
n
i
a
o
c
c
u
r
s
(
l
o
w
b
o
n
e
m
i
n
e
r
a
l
d
e
n
s
i
t
y
)
.
There
is
also
the
notion
that
different
regions
of
the
body
contain
different
kinds
of
bone
and
was
observed
that
each
of
these
bones
has
a
different
hardness
and
modulus.
Besides
that,
it
was
noticed
that
the
cancellous
bone
in
the
tibia
was
approximately
half
as
hard
as
the
thigh
bone
according
to
[35].
A
mathematical
or
engineered
model
does
not
yet
exist
that
joins
this
knowledge
with
a
mechanic
evaluation
of
materials.
In
addition,
aggregating
this
validated
knowledge
to
new
emerging
biomaterials
would
better
address
current
shortfalls
of
osseointegration,
bone
remodeling,
and
their
associated
mechanical
characteristics
and
properties
and
would
synergistically
improve
our
insights
into
prosthetic/orthopedics
applications.
ACKNOWLEDGMENT
I
want
to
thank
the
library
and
public
services
personnel
of
the
Polytechnic
University
of
Puerto
Rico
to
support
me
in
finding
some
of
the
articles
through
an
interlibrary
loan
agreement
with
other
libraries
around
the
world.
Also,
the
UNEXPO,
Puerto
Ordaz
for
their
constant
support
and
guidance
throughout
these
years.
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Vélez-Cruz & Fariñas-Coronado.
Review-Bone Characterization: Mechanical Properties Based on Non-Destructive Techniques
ISSN-E:
2737-6439
Athenea
Journal
Vol.3,
Núm.
10,
(pp.
16-29)
28
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K.
G.
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Vélez-Cruz & Fariñas-Coronado.
Review-Bone Characterization: Mechanical Properties Based on Non-Destructive Techniques
ISSN-E:
2737-6439
Athenea
Journal
V
o
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.
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,
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ú
m
.
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0
,
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)
29
Alex
J.
Vélez-Cruz
,
is
an
engineering
doctoral
student
and
mechanical
engineer
who
was
born
and
race
in
Puerto
Rico
(PR).
He
is
a
faculty
member
of
the
BME
Department
at
Polytechnic
University
of
PR
and
is
a
young
passionate
researcher
and
an
inventor
that
work
constanly
is
t
h
e
p
r
o
d
u
c
t
d
e
v
e
l
o
p
m
e
n
t
a
r
e
a
w
i
t
h
t
h
e
i
n
t
e
n
t
t
o
s
e
r
v
e
a
n
d
h
e
l
p
people
in
need.
A
U
T
H
O
R
S
Wilfredo
Fariñas
Coronado
is
a
PhD
in
Technical
Sciences,
specialized
in
the
diagnosis
of
breast
cancer.
He
is
the
Head
Department
Director
of
the
Biomedical
Engineering
Department
at
the
Polytechnic
University
of
Puerto
Rico
and
a
senior
researcher
dedicated
to
advancing
and
promoting
technologies
for
the
early
detection
of
cancer.
Vélez-Cruz & Fariñas-Coronado.
Review-Bone Characterization: Mechanical Properties Based on Non-Destructive Techniques
ISSN-E:
2737-6439
Athenea
Journal
V
o
l
.
3
,
N
ú
m
.
1
0
,
(
p
p
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1
6
-
2
9
)