PubMed Health⌕ Search

Biomedical subjects

H M Frost

Publications and source records attributed to H M Frost.

At least 73 records · Page 4Linked to original sources

Perspectives: applications of a biomechanical model of the endochondral ossification mechanism.

A biomechanical model of endochondral ossification (Frost and Jee, 1994. Anat. Rec., 240:435-446) can help to explain: (1) some differences in fracture patterns in children and adults, (2) increased fractures during the human adolescent growth spurt, (3) localization of stress fractures and pseudofractures to cortical instead of trabecular bone, (4) increased bone mass in adult-acquired and childhood obesity, (5) subchondral bone densification and osteopenia in some arthroses, (6) why and where mammals lose spongiosa with aging, (7) why, as percents of the original bone stock, metaphyseal trabecular bone losses with aging usually exceed cortical bone losses, (8) why osteochondritis dissecans and aseptic necroses of bone localize in epiphyses instead of metaphyses, (9) some features of growth plate histology in rickets and the chondrodystrophies, (10) why spontaneous fractures in osteoporotic patients affect vertebral more than metaphyseal spongiosa, (11) why osteopenias develop in most chronic, debilitating diseases, and (12) why histomorphometric values can differ in iliac bone biopsies obtained by the "vertical" Jamshidi and "horizontal" Bordier-Meunier techniques.

Adolescent↗

Wolff's Law and bone's structural adaptations to mechanical usage: an overview for clinicians.

Basic Multicellular Unit-based bone remodeling can lead to the removal or conservation of bone, but cannot add to it. Decreased mechanical usage (MU) and acute disuse result in loss of bone next to marrow; normal and hypervigorous MU result in bone conservation. Bone modeling by resorption and formation drifts can add bone and reshape the trabeculae and cortex to strengthen them but collectively they do not remove bone. Hypervigorous MU turns this modeling on, and its architectural effects then lower typical peak bone strains caused by future loads of the same kind to a threshold range. Decreased and normal MU leave this modeling off. Where typical peak bone strains stay below a 50 microstrain region (the MESr) the largest disuse effects on remodeling occur. Larger strains depress it and make it conserve existing bone. Strains above a 1500 microstrain region (the MESm) tend to turn lamellar bone modeling drifts on. By adding to, reshaping and strengthening bone, those drifts reduce future strains under the same mechanical loads towards that strain region. Strains above a 3000 microstrain region (the MESp) can turn woven bone drifts on to suppress local lamellar drifts but can strengthen bone faster than lamellar drifts can. Such strains also increase bone microdamage and the remodeling that normally repairs it. Those values compare to bone's fracture strain of about 25,000 microstrain.

Adaptation, Physiological↗

Wolff's law: an 'MGS' derivation of Gamma in the Three-Way Rule for mechanically controlled lamellar bone modeling drifts.

The Gamma function in a model called the Three-Way Rule can predict qualitatively some responses of lamellar bone modeling drifts to defined longitudinal bone strain patterns. The derivation of Gamma in this article suggests a way to define it from in vivo longitudinal bond strain measurements. It depends on three operators called M, G and S. Let M equal +1 on any part of a bone surface (the 'study surface') where the local Magnitude of the longitudinal mechanical strains exceeds a threshold that can turn adaptive modeling drifts ON; otherwise let it equal zero. For the cross section of a bone or trabecula that intersects the study surface, let G equal +1 when the Greatest strain over the whole cross section is in tension, but -1 if it is in compression. On a study surface where M = +1, let S equal G in uniaxial loading, but +1 if the Subsurface strain gradient emerging from inside the bone to this study surface is positive, and -1 if this gradient is negative. Then the product of M x G x S yields gamma as +1, 0 or -1, and those are its only permitted values. The values would mean a mechanically induced formation drift, or no drift, or a resorption drift, respectively should begin on that study surface. Gamma can predict the drift patterns in five basic or 'principal' structural adaptations of trabeculae, cortex and whole bones to defined mechanical challenges and bone strain patterns.

Animals↗

The role of changes in mechanical usage set points in the pathogenesis of osteoporosis.

Mechanical usage (MU) effects on modeling drifts and BMU-based remodeling affect bone mass in defined ways. Decreased MU stops additions of bone by modeling and increases removal of bone next to marrow by remodeling. The latter effect thins cortices and reduces trabecular number, thickness, and connectivity. Return to normal MU makes remodeling begin conserving existing bone and leaves modeling still off. Hypervigorous MU can make modeling increase bone mass during growth and makes remodeling keep conserving it in children and adults. These effects can be said to begin when typical bone strains rise through two threshold ranges, one for remodeling and a higher one for modeling. Raising the thresholds while normal MU continues should give bone a spurious disuse message, whereupon disuse effects would begin. The bone anatomic and tissue dynamic patterns in acute and chronic disuse resemble those seen in developing and acquired postmenopausal osteoporosis and in other forms of osteoporosis, too. If some hormones, drugs, and other agents increase those thresholds, this could explain such similarities.

Biomechanical Phenomena↗

On the rat model of human osteopenias and osteoporoses.

The idea that rats cannot model human osteopenias errs. The same mechanisms control gains in bone mass (longitudinal bone growth and modeling drifts) and losses (BMU-based remodeling), in young and aged rats and humans. Furthermore, they respond similarly in rats and man to mechanical influences, hormones, drugs and other agents.

Adult↗

Perspectives: bone's mechanical usage windows.

As mechanical usage (MU) of a bone changes from complete disuse towards maximal vigor, the biologic mechanisms that can adapt it to its MU tend to react predictably. Acute disuse can increase BMU (Basic Multicellular Unit, the remodeling 'packet') creations but reduces how much bone they form, to increase bone loss next to marrow. Normal usage reduces those creations to normal and tends to equalize their resorption and formation; this conserves bone. In mild overloading, BMUs still conserve existing bone, while modeling drifts can begin adding to and/or reshaping it. Severe overloading can increase microdamage alarmingly, its repair by BMUs too, and can cause woven bone formation, anarchic resorption and a regional acceleratory phenomenon. Those ranges of MU vigor can define four 'windows'. An adapted window should apply to healthy, normally active adult mammals, and a mild overload window to healthy, normally active growing ammals. The biologic responses in the pathologic window could explain among other things some total joint and internal fixation failures, some pathologic fractures and some bone healing and sports medicine problems.

Adaptation, Physiological↗

Perspectives on artificial joint design.

Due to poor interdisciplinary communication, many artifical joint designs fail to account for some features that normally allow bones to survive for life. In part, these features concern modeling drifts and remodeling basic multicellular units (BMUs), the microdamage thresholds of bone, its load-grain alignment and shear lock properties, load focusing and defocusing, mechanical usage/strain thresholds for controlling the biological mechanisms, and the regional acceleratory phenomenon. This article reviews briefly some major aspects of these features and suggests how implant design might account for them.

Biocompatible Materials↗

A new direction for osteoporosis research: a review and proposal.

This article suggests why drugs that only reduce the activity of existing osteoclasts or enhance the activity of existing osteoblasts probably cannot cure the osteopenias associated with most osteoporoses. Instead they should add only limited amounts of bone, which should begin to disappear after treatment stops. That behavior depends on these facts. Different threshold ranges of mechanical bone strains control gains and losses of bone mass. One threshold controls gains by modeling drifts, and a lower one controls losses by remodeling BMUs. A drug that does not change those thresholds should limit gains (or losses) of bone during indefinitely continued treatment. Success in curing those osteopenias should require learning how to change the thresholds.

Biomechanical Phenomena↗

Skeletal structural adaptations to mechanical usage (SATMU): 1. Redefining Wolff's law: the bone modeling problem.

From the nature of a bone's endload and its local surface strains, the theory computes a modeling operator, Gamma (gamma), that predicts whether mechanical factors will cause lamellar bone modeling drifts, and where and of what kind. A given mechanical bone strain history then provides a separate modeling rate function, M, to specify the rate of such modeling drifts as fractions of the largest possible ones. Multiplying the two functions, e.g., gamma.M, then predicts mechanically controlled bone modeling responses for cortical and trabecular bone, both quantitatively and qualitatively. The theory correctly predicts each of the 6 known "principal adaptations" of lamellar bone, which provide a critical test of any such theory for this organ. The theory accounts for biologic, biomechanical, and clinical-pathologic knowledge not available in Wolff's time nor accounted for by most biomechanicians since. Existing proven methods can provide all numerical data needed to satisfy the theory's mathematical equations and already suggest provisional values for most of them. Its originator views the theory as the kernel of more and better theories to come rather than a finished work, a kernel that suggests a new and in some respects novel logical framework for analysing the problems, and a kernel that invites critique, refinement, and/or exploitation by others.

Adaptation, Physiological↗

Skeletal structural adaptations to mechanical usage (SATMU): 2. Redefining Wolff's law: the remodeling problem.

Basic multicellular unit (BMU)-based remodeling of lamellar bone causes bone turnover, net gains and losses of bone on some bone surfaces or "envelopes," and a remodeling space comprising bone temporarily absent due to evolving resorption spaces and incomplete refilling of them by new bone. Those features depend a) on how many new BMU arise annually, b) on how much bone each BMU has resorbed and c) formed upon its completion, and d) on how long the typical BMU takes to become completed. Because a, b, and c have limiting or maximal values in life that direct and/or indirect effects of mechanical usage of the skeleton can change, the theory presented here derives mechanical usage functions that express what fractions of those maxima a given mechanical usage history allows to happen. The theory predicts some changes in bone formation, resorption, balance, turnover, and remodeling space that depend on how remodeling responds to the vigor of a subject's mechanical usage. The theory can predict specific effects of specific mechanical challenges that experiments can test, and it fits abundant published evidence. As the kernel of a new approach to the problem it awaits critique and refinement by others. It plus the 3-way rule can redefine Wolff's law conceptually and also in mathematical and quantifiable form.

Adaptation, Physiological↗

Skeletal structural adaptations to mechanical usage (SATMU): 3. The hyaline cartilage modeling problem.

A chondral growth/force response curve predicts how intact hyaline cartilage plates grow in vivo under typical peak mechanical unit loads and gradients thereof in healthy immature mammals. Growth under tension would increase as tension rises from zero to a level that damages the tissue. Under compression, growth would increase as the load rises from zero to a level at which growth becomes maximal (the growth-ascending limb of the curve). Further increases in compression loads retard growth and large enough increases can stop it entirely (the growth-descending limb of the curve). For equal changes in loads, the smallest growth change would occur under tension; the largest change would occur on the growth-descending part of the curve. Under zero load a respectable "baseline growth" still occurs. Those effects are superimposed on inherent differences in growth potential of different chondral plates, differences that are determined partly in utero and by the genome. The curve's features can explain many anatomical facts, including the ball-and-socket ankle, joint alignment in the valgus-varus sense, hip dislocations in spasticity, different epiphyseal heights, short bones in paralysed limbs, long bone overgrowth after fractures, why some joint surfaces remain concave and others convex throughout growth, and why some growth plates are domed instead of flat. The above phenomena can be expressed mathematically, and a phenomenologic basic logical framework for doing that is suggested.

Adaptation, Physiological↗

Skeletal structural adaptations to mechanical usage (SATMU): 4. Mechanical influences on intact fibrous tissues.

This paper proposes that the growth in length of living fibrous tissue structures (tendon, ligament, fascia) responds primarily to circulating systemic rather than mechanical factors. However, growth of the thickness of those structures responds primarily to their mechanical tension loads in the special sense that, when the tissue's typical peak mechanical strains exceed a threshold value, its cells begin to add new collagen to increase its thickness, strength, and tension stiffness. When subsequent peak strains reduce to the threshold value, then further additions of collagen stop. That process defines mechanically controlled modeling of fibrous tissues. The collagen in these tissues can also develop mechanical microdamage (MDx) under repeated tension load-deload cycles. Special maintenance mechanisms normally repair that MDx to prevent accumulations that would threaten structural integrity. As a result, spontaneous complete ruptures of these structures can happen when MDx production exceeds its repair. These maintenance mechanisms also prevent gradual stretching under continuous tension loads, a process the author suggests calling creep compensation. When the creep compensation mechanism becomes incompetent, structures can stretch under continuous loads; when it becomes overactive, contractures can occur. The above meld of fact and inference provides the kernel of a general theory for the responses of the architecture and mechanical competence of intact fibrous tissues to mechanical usage.

Adaptation, Physiological↗