Assignment 1: Biomechanics (MECH9017) : Professor: Patrick Wulliamoz
Assignment 1: Biomechanics (MECH9017) : Professor: Patrick Wulliamoz
Assignment 1: Biomechanics (MECH9017) : Professor: Patrick Wulliamoz
In summary, the higher the mineral content in the bones, the denser they
are. Furthermore, the denser the bones are, the stronger they get and the less
likely they are to suffer fractures [11]. Healthy bones give the body a higher
mobility capacity and protects it from lesions. Unhealthy bones, on the other
1
Question 1
T-score and Z-score are two methods used to describe the outcomes of a
bone density test. The T-score method is a comparison of bone density to that of
a healthy young adult reference population and its number of units — or standard
deviations — show whether bone density is above or below the average. The Z-
score method is the number of standard deviations above or below what would
be expected for someone at the reference population age, gender, weight,
ethnicity, or race. If the Z-score is substantially higher or lower than the reference
average, further tests are required to understand the root of the problem [11].
Dual x-ray absorptiometry tests scans (DEXA), also known as bone
densitometry, uses a relatively small dose of ionizing radiation to provide images
that help assessing bone loss. This scan is the most suitable test for assessing
bone mineral density according to WHO, which defines the diagnostic criteria for
osteoporosis based on T-scores. The figures for healthy and unhealthy bones are
classified as follows based on a young adult reference population [9]:
Bone quality, as well as bone mass and geometry, are the determinants
of bone strength. Bone quality encompasses many aspects of bone structure and
composition, including bone turnover, which has more impact compared to others
(see figure 2), microarchitecture, mineralisation density and distribution,
microdamage level and repair, and bone matrix and mineral composition [13].
The assessment and measurement of each one of them plays a key role
when it comes to defining accurately bone quality. The interest for new methods
started from poor results used in traditional methods such as bone densitometry
whereby fails to predict risks of fracture. Juliet Compston [13] describes in her
article, which is summarized in the figure below, recent developed techniques
that can be used to measure each of the aspects shown in Figure 3:
2
Question 2
Osteoblasts, osteocytes, osteoclasts, and osteogenic cells are the four cell
types present in the bone. Each cell type has a distinct function and can be found
in various locations in the bone. Osteoblasts are the cells responsible for forming
new bone. They are located in the periosteum and endosteum, which is the
growing parts of the bone. The osteoblast becomes stuck inside the secreted
matrix surrounding it as it calcifies and thus it transforms into an osteocyte which
is the most common type of bone cell. Osteocytes are cells that live inside the
bones. They're also made by osteoblasts. When new bone is being created,
some osteoblasts transform into osteocytes, which are then surrounded by new
bone. However, since they send out long branches that bind to other osteocytes,
they are not isolated. These cells can detect stresses or cracks in the bone and
help osteoclasts dissolve the bone in the right places. Osteoclasts are large
multinuclear cell that is involved in bone resorption. They are similar to white
blood cells and come from the bone marrow.
3
Question 3
[1] Sozen, T., Ozisik, L. and Calik Basaran, N. (2017) ‘An overview and
management of osteoporosis’, European Journal of Rheumatology, 4(1), pp. 46–
56. doi: 10.5152/eurjrheum.2016.048.
[3] Adachi, T. et al. (2009) ‘Osteocyte calcium signalling response to bone matrix
deformation’, Journal of Biomechanics, 42(15), pp. 2507–2512. doi:
10.1016/j.jbiomech.2009.07.006.
[4] Frost, H. M. (1997) ‘Why do marathon runners have less bone than weight
lifters? A vital-biomechanical view and explanation’, Bone, 20(3), pp. 183–189.
doi: 10.1016/S8756-3282(96)00311-0.
[6] Hazenberg, J. G., Taylor, D. and Lee, T. C. (2007) ‘The role of osteocytes and
bone microstructure in preventing osteoporotic fractures’, Osteoporosis
International, 18(1), pp. 1–8. doi: 10.1007/s00198-006-0222-y.
[12] US Department of Health and Human Services (2004) ‘Bone health and
osteoporosis: a report of the Surgeon General’, US Health and Human Services,
p.437. Available at:
http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Bone+Health
+and+Osteoporosis+A+Report+of+the+Surgeon+General#0.
[14] Hart, R. T. (1995) ‘Review and overview of net bone remodeling’, WIT
transactions on Biomedicine and Health, 2, p. 9. Available at:
https://www.witpress.com/Secure/elibrary/papers/BIO95/BIO95032FU.pdf.