Kurt J Koester

Publications of Kurt J Koester

• Microindentation for in vivo measurement of bone tissue mechanical properties in humans.

  Authors: Adolfo Diez-Perez, Roberto Güerri, Xavier Nogues, Enric Cáceres, Maria Jesus Peña, Leonardo Mellibovsky, Connor Randall, Daniel Bridges, James C Weaver, Alexander Proctor, Davis Brimer, Kurt J Koester, Robert O Ritchie, Paul K Hansma

  Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research. 02/2010; 25(8):1877-85.

  Bone tissue mechanical properties are deemed a key component of bone strength, but their assessment requires invasive procedures. Here we validate a new instrument, a reference point indentationBone tissue mechanical properties are deemed a key component of bone strength, but their assessment requires invasive procedures. Here we validate a new instrument, a reference point indentation (RPI) instrument, for measuring these tissue properties in vivo. The RPI instrument performs bone microindentation testing (BMT) by inserting a probe assembly through the skin covering the tibia and, after displacing periosteum, applying 20 indentation cycles at 2 Hz each with a maximum force of 11 N. We assessed 27 women with osteoporosis-related fractures and 8 controls of comparable ages. Measured total indentation distance (46.0 +/- 14 versus 31.7 +/- 3.3 microm, p = .008) and indentation distance increase (18.1 +/- 5.6 versus 12.3 +/- 2.9 microm, p = .008) were significantly greater in fracture patients than in controls. Areas under the receiver operating characteristic (ROC) curve for the two measurements were 93.1% (95% confidence interval [CI] 83.1-100) and 90.3% (95% CI 73.2-100), respectively. Interobserver coefficient of variation ranged from 8.7% to 15.5%, and the procedure was well tolerated. In a separate study of cadaveric human bone samples (n = 5), crack growth toughness and indentation distance increase correlated (r = -0.9036, p = .018), and scanning electron microscope images of cracks induced by indentation and by experimental fractures were similar. We conclude that BMT, by inducing microscopic fractures, directly measures bone mechanical properties at the tissue level. The technique is feasible for use in clinics with good reproducibility. It discriminates precisely between patients with and without fragility fracture and may provide clinicians and researchers with a direct in vivo measurement of bone tissue resistance to fracture.

• The effect of aging on crack-growth resistance and toughening mechanisms in human dentin.

  Authors: Kurt J Koester, Joel W Ager, Robert O Ritchie

  Biomaterials. 04/2008; 29(10):1318-28.

  Crack-growth experiments in human dentin have been performed in situ in an environmental scanning electron microscope to measure, for the first time, the crack-growth resistance curve (R-curve) forCrack-growth experiments in human dentin have been performed in situ in an environmental scanning electron microscope to measure, for the first time, the crack-growth resistance curve (R-curve) for clinically relevant (<250 microm) crack extensions and to simultaneously identify the salient toughening mechanisms. "Young" dentin from donors 19-30 years in age and "aged" dentin from donors 40-70 years in age were evaluated. The "young" group had 0-4% of its tubules filled with apatite; the "aged" group was subdivided into "opaque" with 12-32% filled tubules and "transparent" with 65-100% filled tubules. Although crack-initiation toughnesses were similar, the crack-growth resistance of "young" dentin was higher by about 40% compared to "aged" dentin. Mechanistically, this behavior is interpreted in terms of three phenomena: (i) gross crack deflection of the growing crack, (ii) microcracks which initiated at unfilled tubules in the high stress region in the vicinity of a propagating crack (no microcracks formed at filled tubules), and (iii) crack propagation which followed a local trajectory through unfilled tubules and deflected around filled tubules. The higher toughness of the "young" dentin was related to enhanced microcracking (at unfilled tubules) ahead of the growing crack, which (i) shields the crack by activating multiple crack tips and by reducing the local stress intensity through crack deflection and (ii) leads to the formation of crack bridges from "uncracked ligaments" due to the incomplete coalescence of these microcracks with the main crack tip. With age, the role of these toughening mechanisms was diminished primarily to the lower fraction of unfilled, and hence microcracked, tubules.

• The degree of bone mineralization is maintained with single intravenous bisphosphonates in aged estrogen-deficient rats and is a strong predictor of bone strength.

  Authors: Wei Yao, Zhiqiang Cheng, Kurt J Koester, Joel W Ager, Mehdi Balooch, Aaron Pham, Solomon Chefo, Cheryl Busse, Robert O Ritchie, Nancy E Lane

  Bone. 11/2007; 41(5):804-12.

  The treatment of osteoporotic women with bisphosphonates significantly reduces the incidence of bone fractures to a degree greater than can be explained by an increase in bone mineral density. InThe treatment of osteoporotic women with bisphosphonates significantly reduces the incidence of bone fractures to a degree greater than can be explained by an increase in bone mineral density. In this study, 18-month Fischer 344 rats were ovariectomized and treated with a single dose of risedronate (intravenous, iv, 500 microg), zoledronic acid (iv, 100 microg) or continuous raloxifene (2 mg/kg, po, 3x/week). High resolution microCT was used to measure lumbar vertebral bone microarchitecture, the degree of bone mineralization (DBM) and the distribution of mineral. Small angle X-ray scattering was used to investigate mineral crystallinity. We found prolonged estrogen deficiency, reduced trabecular bone volume, and increased micro architecture bone compression strength lowered the degree of mineralization. Treatment with resorptive agents (bisphosphonates>raloxifene) prevented the loss of mineralization, trabecular bone volume and bone compression strength. Crystal size was not changed with OVX or with anti-resorptive treatments. In conclusion, in the aged estrogen-deficient rat model, single intravenous doses of two bisphosphonates were effective in maintaining the compressive bone strength for 180 days by reducing bone turnover, and maintaining the DBM to a greater degree than with raloxifene.