Ramazan Kayacan

The Effect of Gamma Radiation Sterilization on the Fatigue Crack Propagation Resistance of Human Cortical Bone

BACKGROUNDnClinical evidence has suggested that the rate of fracture in allografts sterilized with gamma radiation may be higher than that in controls. Gamma radiation sterilization has been shown to affect the post-yield properties of bone but not the elastic modulus. Since most allograft fractures occur with subcritical loads during activities of daily living, it may be that the fatigue properties of irradiated allografts are diminished. In this study, the fatigue crack propagation behavior of cortical bone sterilized with gamma radiation was compared with that of gender and age-matched controls. We hypothesized that gamma radiation significantly reduces the resistance of cortical bone to fatigue crack growth.nnnMETHODSnSpecimens for fatigue crack propagation testing were machined from four pairs of fresh-frozen human femora obtained from four individuals (a younger male, younger female, older male, and older female donor). Half of the specimens were sterilized with 31.7 kGy of gamma radiation. The specimens were cyclically loaded to failure in a servohydraulic testing system, and crack growth was monitored. The cyclic stress intensity factor and the fatigue crack growth rate were calculated to examine the kinetics of fatigue crack growth. Following testing, the damage zone around the fracture plane was analyzed histologically.nnnRESULTSnThe morphology and kinetics of crack growth in irradiated specimens differed from the control data. Overall, the irradiated bone was significantly less resistant to fatigue crack growth than was control tissue (p < 0.05). There was less microdamage associated with fracture in the irradiated specimens than in the control specimens, with the exception of the bone from the older female donor.nnnCONCLUSIONSnGamma radiation sterilization significantly reduces the fatigue crack propagation resistance of cortical bone. Irradiated specimens also demonstrate a smaller amount of microdamage along the fracture plane. These findings may be due to ultrastructural alterations in the collagen matrix caused by radiation.nnnCLINICAL RELEVANCEnThis study suggests that, despite having pre-yield mechanical properties that are similar to those of nonirradiated bone, gamma-radiation-sterilized allograft may be more predisposed to fracture even under the subcritical loads that occur during the activities of daily living.

The effect of staining on the monotonic tensile mechanical properties of human cortical bone

Microdamage in the form of microcracks has been observed in cortical bone following in vivo and in vitro fatigue loading. It has been suggested that bone has an inherent ability to repair microdamage at physiological activity levels. If the biological remodelling and repair process cannot keep up with the rate of damage accumulation, as in ageing bone and in individuals such as athletes and military recruits, microdamage may accumulate even at physiological activity levels. Such microdamage accumulation is thought to contribute to stress and fragility fractures. It is therefore important to obtain quantitative data on the rate of damage accumulation so as to understand the etiology of skeletal fractures. Sequential labelling of microdamage using fluorochrome stains at different stages of mechanical loading is becoming standard for assessing damage evolution. Although verification of this staining technique is provided in the literature, it has not yet been reported if the stains change the mechanical properties of cortical bone. In this study, monotonic tensile tests were performed to investigate the effect of the staining on the monotonic tensile mechanical properties of cortical bone. Forty‐eight specimens were machined from human femora obtained from three male subjects, aged 52–55 years, and all 48 specimens were systematically divided into one control and three treatment groups. Specimens in the first (n = 12) and second treatment groups (n = 12) were stained with alizarin complexone and calcein (0.0005 m), respectively, for 16 h under 50 mmHg vacuum. Specimens in the third treatment group (n = 12) were kept in calcium‐supplemented saline solution under the same conditions of the first and second treatment groups. Specimens in the control group (n = 12) were removed from the freezer prior to testing and allowed to thaw at room temperature in saline solution. Differences among the mean values of the mechanical properties for four testing groups were determined by the Mann–Whitney test at a significance level of P < 0.05. The statistical results indicated that the chelating stains and the staining conditions have no significant effect on the mechanical properties of the cortical bone under monotonic tensile loading. This study demonstrated that microcrack labelling with the chelating stains under aforementioned conditions (stain concentration, staining time, etc.) is a reliable method in that staining cortical bone with alizarin complexone and calcein prior to testing does not affect tensile properties.

Effects of gamma radiation sterilization and strain rate on compressive behavior of equine cortical bone

OBJECTIVESnGamma radiation has been widely used for sterilization of bone allograft. However, sterilization by gamma radiation damages the material properties of bone which is a major clinical concern since bone allograft is used in load bearing applications. While the degree of this damage is well investigated for quasi-static and cyclic loading conditions, there does not appear any information on mechanical behavior of gamma-irradiated cortical bone at high speed loading conditions. In this study, the effects of gamma irradiation on high strain rate compressive behavior of equine cortical bone were investigated using a Split Hopkinson Pressure Bar (SHPB). Quasi-static compression testing was also performed.nnnMETHODSnEquine cortical bone tissue from 8year old retired racehorses was divided into two groups: non-irradiated and gamma-irradiated at 30kGy. Quasi-static and high strain rate compression tests were performed at average strain rates of 0.0045/s and 725/s, respectively.nnnRESULTSnAgreeing with previous results on the embrittlement of cortical bone when gamma-irradiated, the quasi-static results showed that gamma-irradiation significantly decreased ultimate strength (9%), ultimate strain (27%) and toughness (41%), while not having significant effect on modulus of elasticity, yield strain and resilience. More importantly, contrary to what is typically observed in quasi-static loading, the gamma-irradiated bone under high speed loading showed significantly higher modulus of elasticity (45%), ultimate strength (24%) and toughness (26%) than those of non-irradiated bone, although the failure was at a similar strain.nnnSIGNIFICANCEnUnder high speed loading, the mechanical properties of bone allografts were not degraded by irradiation, in contrast to the degradation measured in this and prior studies under quasi-static loading. This result calls into question the assumption that bone allograft is always degraded by gamma irradiation, regardless of loading conditions. However, it needs further investigation to be translated positively in a clinical setting.

GAMA RADYASYONU İLE STERİLİZE EDİLMİŞ KORTİKAL KEMİĞİN DİNAMİK YÜK ALTINDA MEKANİK DAVRANIŞININ İNCELENMESİ

The effect of gamma radiation on the dynamic mechanical properties of cortical bone was accessed in this study. The cortical bone samples were divided into two groups: an untreated control specimens and specimens subjected to gamma radiation sterilization. A dose of 30 kGy was used to sterilize the bone samples. Unlike the quasi-static mechanical tests, dynamic mechanical test have shown that gamma-irradiated cortical bone has increased yield stress, ultimate stress and modulus of elasticity. Statistical differences were determined by the Mann–Whitney test at a significance level of P<0.05