Modelling loading and growth of long bones Modelling loading and growth of long bones

Abstract: The long bones grow by the process of endochondral ossification, which occurs at the growth plate. This process is regulated by biological factors and mechanical factors. The biological factors which contribute to endochondral ossification process are genes, hormones, nutrients etc. The mechanical factor is the load acting on the bone. The major forces on the bone are due to joint contact load and muscle forces, which induce stresses in the bone. Carter and Wong proposed in a theory that cyclic or intermittent octahedral shear stress promotes the bone growth and cyclic or intermittent hydrostatic compressive stress inhibits the bone growth. Previously this theory has been used to predict the morphological development of long bones, but with studies using simplified femur and growth plate models. Furthermore, the Carter and Wong theory has a limitation that it does not intrinsically incorporate the resulting growth direction.In the first study, the importance of a subject-specific growth plate over a simplified growth plate has been studied, and growth has been simulated using two different growth direction models: Femoral neck shaft deformation direction and minimum shear stress direction. This study favors the minimum shear stress growth direction model, as it is less sensitive to applied boundary condition than the femoral neck shaft deformation direction model.The second study aims to understand how different muscle groups affect the bone growth tendency. Subject-specific femur and growth plate models of able-bodied children were used. The muscle forces and associated hip contact force from specific muscle groups were applied, and neck shaft angle and femoral anteversion growth tendencies were predicted. This study indicated a tendency for reduction of neck shaft angle and femoral anteversion. Hip abductor muscle forces contribute most, and hip adductor muscle forces least, to bone growth rate.Accurate prediction of bone growth tendency and knowledge of the influence of different muscle groups on bone growth tendency may help in better treatment planning for children at risk of developing bone deformity problems.