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Review
. 2017 Mar 16:6:87-100.
doi: 10.1016/j.bonr.2017.03.002. eCollection 2017 Jun.

Bone fracture healing in mechanobiological modeling: A review of principles and methods

Mohammad S Ghiasi  1 , Jason Chen  2 , Ashkan Vaziri  3 , Edward K Rodriguez  4 , Ara Nazarian  5
Affiliations
Review

Bone fracture healing in mechanobiological modeling: A review of principles and methods

Mohammad S Ghiasi et al. Bone Rep. .

Abstract

Bone fracture is a very common body injury. The healing process is physiologically complex, involving both biological and mechanical aspects. Following a fracture, cell migration, cell/tissue differentiation, tissue synthesis, and cytokine and growth factor release occur, regulated by the mechanical environment. Over the past decade, bone healing simulation and modeling has been employed to understand its details and mechanisms, to investigate specific clinical questions, and to design healing strategies. The goal of this effort is to review the history and the most recent work in bone healing simulations with an emphasis on both biological and mechanical properties. Therefore, we provide a brief review of the biology of bone fracture repair, followed by an outline of the key growth factors and mechanical factors influencing it. We then compare different methodologies of bone healing simulation, including conceptual modeling (qualitative modeling of bone healing to understand the general mechanisms), biological modeling (considering only the biological factors and processes), and mechanobiological modeling (considering both biological aspects and mechanical environment). Finally we evaluate different components and clinical applications of bone healing simulation such as mechanical stimuli, phases of bone healing, and angiogenesis.

Keywords: Angiogenesis; Biological modeling; Bone fracture healing; Callus; Computational modeling; Finite element; Growth factors; Hematoma; Mathematical modeling; Mechanical stimuli; Mechanobiological modeling.

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Figures

Fig. 1
Fig. 1
Clinical example of humerus fracture healing.
Fig. 2
Fig. 2
Different mechanobiological regulations presented: A) Prendergast et al. (1997) B) Carter et al. (1998) C) Claes and Heigele (1999) (with permission of reuse from the publisher).
Fig. 3
Fig. 3
Strain measurement by DIC method: A) before loading, B) after loading, and C) displacement vector. Morgan et al. (2010) (with permission of reuse from the publisher).
Fig. 4
Fig. 4
Schematic of the 4-phase conceptual model for bone fracture healing by Pivonka and Dunstan (2012) (with permission of reuse from the publisher).
Fig. 5
Fig. 5
Schematic of BHN conceptual model by Elliott et al. (2016).
Fig. 6
Fig. 6
Schematic of mathematical modeling: A) developed by Geris et al. (2008) and B) developed by Carlier et al. (2012) (B-1: scale map and B-2: model) (with permission of reuse from the publishers).
Fig. 7
Fig. 7
Schematic of a general mechano-bioregulatory model.
Fig. 8
Fig. 8
exponential and linear patterns of healing in chondrogenesis and bone formation zones of mechanobiological regulations, respectively, presented by Alierta et al. (2014).
Fig. 9
Fig. 9
Mechanobiological regulations by Prendergast et al. (1997) without bone resorption (a) and with bone resorption (b).
Fig. 10
Fig. 10
Algorithm of model for angiogenesis of bone fracture healing by Checa et al. (Checa and Prendergast, 2009) (with permission of reuse from the publisher).
Fig. 11
Fig. 11
Study of fixation stability via modeling and experimental study by Wehner et al. (Wehner et al., 2010) (with permission of reuse from the publisher).
See this image and copyright information in PMC

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