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1

Alwis, G. "Bone strength beyond bone mass." Galle Medical Journal 25, no. 2 (June 16, 2020): 19. http://dx.doi.org/10.4038/gmj.v25i2.8020.

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2

Yingling, Vanessa R., Benjamin Ferrari-Church, and Ariana Strickland. "Tibia functionality and Division II female and male collegiate athletes from multiple sports." PeerJ 6 (September 11, 2018): e5550. http://dx.doi.org/10.7717/peerj.5550.

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Background Bone strength is developed through a combination of the size and shape (architecture) of a bone as well as the bone’s material properties; and therefore, no one outcome variable can measure a positive or negative adaptation in bone. Skeletal robusticity (total area/ bone length) a measure of bones external size varies within the population and is independent of body size, but robusticity has been associated with bone strength. Athletes may have similar variability in robusticity values as the general population and thus have a wide range of bone strengths based on the robustness of their bones. Therefore, the purpose of this study was to determine if an athlete’s bone strength and cortical area relative to body size was dependent on robusticity. The second aim was to determine if anthropometry or muscle function measurements were associated with bone robusticity. Methods Bone variables contributing to bone strength were measured in collegiate athletes and a reference group using peripheral quantitative computed tomography (pQCT) at the 50% tibial site. Bone functionality was assessed by plotting bone strength and cortical area vs body size (body weight x tibial length) and robustness (total area/length) vs body size. Bone strength was measured using the polar strength-strain index (SSIp). Based on the residuals from the regression, an athlete’s individual functionality was determined, and two groups were formed “weaker for size” (WS) and “stronger for size” (SS). Grip strength, leg extensor strength and lower body power were also measured. Results Division II athletes exhibited a natural variation in (SSIp) relative to robusticity consistent with previous studies. Bone strength (SSIp) was dependent on the robusticity of the tibia. The bone traits that comprise bone strength (SSIp) were significantly different between the SS and WS groups, yet there were minimal differences in the anthropometric data and muscle function measures between groups. A lower percentage of athletes from ball sports were “weaker for size” (WS group) and a higher percentage of swimmers were in the WS group. Discussion A range of strength values based on robusticity occurs in athletes similar to general populations. Bones with lower robusticity (slender) were constructed with less bone tissue and had less strength. The athletes with slender bones were from all sports including track and field and ball sports but the majority were swimmers. Conclusions Athletes, even after optimal training for their sport, may have weaker bones based on robusticity. Slender bones may therefore be at a higher risk for fracture under extreme loading events but also yield benefits to some athletes (swimmers) due to their lower bone mass.
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3

Delaney, Miriam. "Understanding Bone Strength." Endocrinologist 16, no. 2 (March 2006): 79–85. http://dx.doi.org/10.1097/01.ten.0000203584.18296.ff.

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4

Marchant, J. N., and D. M. Broom. "Effects of dry sow housing conditions on muscle weight and bone strength." Animal Science 62, no. 1 (February 1996): 105–13. http://dx.doi.org/10.1017/s1357729800014387.

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AbstractConfinement has been shown to affect bone strenth in poultry but this weakness has not been documented in other species housed in confinement. The objectives of this experiment were to compare muscle weight and bone strength in non-pregnant sows, of similar age and parity, housed throughout eight or nine pregnancies in two different dry sow systems: (1) individually in stalls and (2) communally in a large group. Following slaughter, the left thoracic and pelvic limbs were dissected and 14 locomotor muscles removed and c. ???lied. A proportional muscle weight was then calculated by dividing individual muscle weight (g) by total body weight (kg). Where there were significant differences, stall-housed sows had lower absolute and proportional muscle weights than group-housed sows. The left humerus and femur were also removed. The bones were broken by a three-point bend test using an Instron Universal Tester. Both bones from stall-housed sows had breaking strengths that were about two-thirds those of group-housed sows. The results indicate that confinement of sows, with a consequent lack of exercise, results in reduction of muscle weight and considerable reduction of bone strength.
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5

Gøthgen, Charlotte Buch, Frank Linde, Ivan Hvid, and Per Kjærsgaard-Andersen. "Cement-bone interface strength: Influence of bone strength and cement penetration." Journal of Biomechanics 23, no. 4 (January 1990): 365. http://dx.doi.org/10.1016/0021-9290(90)90072-b.

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6

Okuma, Toshitada. "Magnesium and bone strength." Nutrition 17, no. 7-8 (July 2001): 679–80. http://dx.doi.org/10.1016/s0899-9007(01)00551-2.

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7

Boskey, A. L., T. M. Wright, and R. D. Blank. "Collagen and Bone Strength." Journal of Bone and Mineral Research 14, no. 3 (March 1, 1999): 330–35. http://dx.doi.org/10.1359/jbmr.1999.14.3.330.

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8

Kiebzak, Gary M., and Paul D. Miller. "Determinants of Bone Strength." Journal of Bone and Mineral Research 18, no. 2 (February 1, 2003): 383–84. http://dx.doi.org/10.1359/jbmr.2003.18.2.383.

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9

Hughes, Clare. "Beer increases bone strength." BMJ 325, Suppl S6 (December 1, 2002): 0212446a. http://dx.doi.org/10.1136/sbmj.0212446a.

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10

Morild, Inge, Nils Roar Gjerdet, and J. Chr Giertsen. "Bone strength in infants." Forensic Science International 60, no. 1-2 (June 1993): 111–19. http://dx.doi.org/10.1016/0379-0738(93)90099-v.

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11

TURNER, C. H. "Bone Strength: Current Concepts." Annals of the New York Academy of Sciences 1068, no. 1 (April 1, 2006): 429–46. http://dx.doi.org/10.1196/annals.1346.039.

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12

Dempster, David W. "Bone microarchitecture and strength." Osteoporosis International 14 (September 1, 2003): 54–56. http://dx.doi.org/10.1007/s00198-003-1474-4.

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13

Burr, David. "Microdamage and bone strength." Osteoporosis International 14 (September 1, 2003): 67–72. http://dx.doi.org/10.1007/s00198-003-1476-2.

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14

Bazarra-Fernandez, Antonio. "Bone strength gauge research." Bone 43 (October 2008): S114. http://dx.doi.org/10.1016/j.bone.2008.07.142.

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15

Ammann, P. "Bone strength and ultrastructure." Osteoporosis International 20, no. 6 (April 2, 2009): 1081–83. http://dx.doi.org/10.1007/s00198-009-0866-5.

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16

Jindal, MK, OP Lakhwani, SK Kapoor, RK Chandoke, Omkar Kaur, BB Arora, and Keerty Garg. "Correlation between bone histomorphometry and bone strength." Tropical Journal of Medical Research 20, no. 1 (2017): 25. http://dx.doi.org/10.4103/1119-0388.198107.

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17

Ott, Susan M. "Bone strength: more than just bone density." Kidney International 89, no. 1 (January 2016): 16–19. http://dx.doi.org/10.1016/j.kint.2015.11.004.

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18

Turner, Charles. "Age, bone material properties, and bone strength." Calcified Tissue International 53, S1 (February 1993): S32—S33. http://dx.doi.org/10.1007/bf01673399.

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19

Lou, Ching Wen, Wen Cheng Chen, Chao Tsang Lu, Cheng Chun Huang, and Jia Horng Lin. "Compressive Strength of Porous Bone Cement/Polylactic Acid Composite Bone Scaffolds." Applied Mechanics and Materials 365-366 (August 2013): 1062–65. http://dx.doi.org/10.4028/www.scientific.net/amm.365-366.1062.

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Calcium phosphate bone cement (CPC), a bioceramic, is commonly used in artificial bone scaffold for impaired bones. In this study, CPC is mixed with polylactide (PLA) fibers and porogenic agent to form CPC/PLA composite bone scaffold. The compressive strength of the resulting bone scaffolds is evaluated and the fractured cross-section is observed by a scanning electron microscope (SEM), thereby determining the influence of fiber length. The experimental results show that the shorter the fiber is, the greater the compressive strength is.
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20

Sul, Young-Taeg, Carina Johansson, and Tomas Albrektsson. "A novel in vivo method for quantifying the interfacial biochemical bond strength of bone implants." Journal of The Royal Society Interface 7, no. 42 (April 15, 2009): 81–90. http://dx.doi.org/10.1098/rsif.2009.0060.

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Quantifying the in vivo interfacial biochemical bond strength of bone implants is a biological challenge. We have developed a new and novel in vivo method to identify an interfacial biochemical bond in bone implants and to measure its bonding strength. This method, named biochemical bond measurement (BBM), involves a combination of the implant devices to measure true interfacial bond strength and surface property controls, and thus enables the contributions of mechanical interlocking and biochemical bonding to be distinguished from the measured strength values. We applied the BBM method to a rabbit model, and observed great differences in bone integration between the oxygen (control group) and magnesium (test group) plasma immersion ion-implanted titanium implants (0.046 versus 0.086 MPa, n =10, p =0.005). The biochemical bond in the test implants resulted in superior interfacial behaviour of the implants to bone: (i) close contact to approximately 2 μm thin amorphous interfacial tissue, (ii) pronounced mineralization of the interfacial tissue, (iii) rapid bone healing in contact, and (iv) strong integration to bone. The BBM method can be applied to in vivo experimental models not only to validate the presence of a biochemical bond at the bone–implant interface but also to measure the relative quantity of biochemical bond strength. The present study may provide new avenues for better understanding the role of a biochemical bond involved in the integration of bone implants.
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21

Ferretti, J. "Bone mass, bone strength, muscle–bone interactions, osteopenias and osteoporoses." Mechanisms of Ageing and Development 124, no. 3 (March 2003): 269–79. http://dx.doi.org/10.1016/s0047-6374(02)00194-x.

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22

Gustafson, S. B., D. M. Blackketter, P. D. Schwarz, and S. E. Klause. "Holding Strength of 4.5 mm Cortical Screws in Polymethylmethacrylate Filled Medullary Cavities of Canine Bone." Veterinary and Comparative Orthopaedics and Traumatology 05, no. 03 (1992): 109–13. http://dx.doi.org/10.1055/s-0038-1633079.

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SummaryThe technique of adding polymethylmethacrylate (PMMA) to the medullary cavities of canine bone significantly increases the screw pullout resistance by 3.6 times over bone without PMMA. This increased holding power per screw would be advantageous when due to the fracture configuration, a minimum number of screws must be used on one or both fracture sides. This would help resist bone shear loosening at the screw/ bone interface by adding the additional pullout strength of the PMMA. Each mm of PMMA filling the medullary cavity is equivalent to adding the pullout strength of an additional 1.0 mm of cortical bone (310.0 N/ mm).Paired femurs were used to evaluate the in vitro mechanical advantages of the holding strength of 4.5 mm orthopaedic bone screws on adult canine bone, with and without the medullary cavity filled with polymethylmethacrylate (PMMA). Maximum cortical screw pullout force and holding strength were significantly greater for bones with the medullary cavity filled with PMMA than for bones without PMMA. Holding strength of PMMA was not different from the holding strength per mm of bone.
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23

Forestier-Zhang, Lydia, and Nick Bishop. "Bone strength in children: understanding basic bone biomechanics." Archives of disease in childhood - Education & practice edition 101, no. 1 (August 12, 2015): 2–7. http://dx.doi.org/10.1136/archdischild-2015-308597.

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24

Riewald, Scott. "Bone of Contention: What Exercises Increase Bone Strength?" Strength and Conditioning Journal 26, no. 1 (2004): 46. http://dx.doi.org/10.1519/1533-4295(2004)026<0046:bocwei>2.0.co;2.

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25

Okazaki, Yoshimitsu, Emiko Hayakawa, Kazumasa Tanahashi, and Jun Mori. "Mechanical Performance of Metallic Bone Screws Evaluated Using Bone Models." Materials 13, no. 21 (October 29, 2020): 4836. http://dx.doi.org/10.3390/ma13214836.

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To evaluate mechanical performance properties of various types of cortical bone screw, cancellous bone screw, and locking bolt, we conducted torsional breaking and durability tests, screw driving torque tests into bone models, and screw pullout tests (crosshead speed: 10 mm/min) after driving torque tests. The 2° proof and rupture torques of a screw, which were estimated from torque versus rotational angle curves, increased with increasing core diameter of the screw. The durability limit of metallic screws obtained by four-point bending durability tests increased with increasing core diameter. The compressive, tensile, and shear strengths of the bone models used for the mechanical testing of orthopedic devices increased with increasing density of the bone model. The strength and modulus obtained for solid rigid polyurethane foam (SRPF) and cellular rigid polyurethane foam (CRPF) lay on the same straight line. Among the three strengths, the rate of increase in compressive strength with the increase in density was the highest. The maximum torque obtained by screw driving torque tests for up to 8.3 rotations (3000°) into the bone models tended to increase with increasing core diameter. In particular, the maximum torque increased linearly with increasing effective surface area of the screw, as newly defined in this work. The maximum pullout load increased linearly with increasing number of rotations and mechanical strength of the bone model. Screws with low driving torque and high pullout load were considered to have excellent fixation and are a target for development.
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26

Bonnick, Sydney Lou. "Noninvasive assessments of bone strength." Current Opinion in Endocrinology, Diabetes and Obesity 14, no. 6 (December 2007): 451–57. http://dx.doi.org/10.1097/med.0b013e3282f154a7.

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27

Turner, C. H. "Exercises for improving bone strength." British Journal of Sports Medicine 39, no. 4 (April 1, 2005): 188–89. http://dx.doi.org/10.1136/bjsm.2004.016923.

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28

Simmonds, Jane. "Optimizing Bone Mass And Strength." Journal of Human Nutrition and Dietetics 20, no. 6 (December 2007): 613–14. http://dx.doi.org/10.1111/j.1365-277x.2007.00823.x.

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29

Friedman, Alan W. "Important Determinants of Bone Strength." JCR: Journal of Clinical Rheumatology 12, no. 2 (April 2006): 70–77. http://dx.doi.org/10.1097/01.rhu.0000208612.33819.8c.

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30

Ammann, P., and R. Rizzoli. "Bone strength and its determinants." Osteoporosis International 14, S3 (March 2003): 13–18. http://dx.doi.org/10.1007/s00198-002-1345-4.

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31

Bilezikian, John P. "Bone strength in primary hyperparathyroidism." Osteoporosis International 14 (September 1, 2003): 113–17. http://dx.doi.org/10.1007/s00198-003-1482-4.

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32

Turner, Charles H., Ann J. Dunipace, and Thomas A. Einhorn. "On fluoride and bone strength." Calcified Tissue International 53, no. 4 (October 1993): 289–90. http://dx.doi.org/10.1007/bf01320916.

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33

Einhorn, Thomas A. "Bone strength: The bottom line." Calcified Tissue International 51, no. 5 (November 1992): 333–39. http://dx.doi.org/10.1007/bf00316875.

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34

Baylink, D. J., J. E. Wergedal, J. R. Farley, T. A. Einhorn, Charles H. Turner, and Ann J. Dunipace. "On fluoride and bone strength." Calcified Tissue International 56, no. 5 (May 1995): 415–18. http://dx.doi.org/10.1007/bf00301613.

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35

Suominen, Harri. "Muscle training for bone strength." Aging Clinical and Experimental Research 18, no. 2 (April 2006): 85–93. http://dx.doi.org/10.1007/bf03327422.

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36

Biewener, Andrew A. "Safety factors in bone strength." Calcified Tissue International 53, S1 (February 1993): S68—S74. http://dx.doi.org/10.1007/bf01673406.

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37

Rubin, Clinton. "Osteocyte function and bone strength." Calcified Tissue International 53, S1 (February 1993): S100—S101. http://dx.doi.org/10.1007/bf01673414.

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38

Martin, Bruce. "Trabecular architecture and bone strength." Calcified Tissue International 53, S1 (February 1993): S120. http://dx.doi.org/10.1007/bf01673419.

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39

Goto, Koji, Keiichi Kawanabe, Shunsuke Fujibayashi, R. Kowalski, and Takashi Nakamura. "Bone-Bonding Strength of a New Composite Bone Cement." Key Engineering Materials 330-332 (February 2007): 827–30. http://dx.doi.org/10.4028/www.scientific.net/kem.330-332.827.

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A composite bone cement designated G2B1 that contains β tricalcium phosphate particles was developed as a bone substitute for percutaneous transpedicular vertebroplasty. In this study, both G2B1 and commercial PMMA bone cement (CMW1) were implanted into proximal tibiae of rabbits with a metal frame fixed on it, and their bone-bonding strengths were evaluated at 4, 8, 12 and 16 weeks after implantation using a detaching test. Some of the specimens were evaluated histologically using Giemsa surface staining and scanning electron microscopy (SEM). It was found that the bone-bonding strength of G2B1 was significantly higher than that of CMW1 at each time point, and significantly increased from 4 weeks to 8 and 12 weeks, while it decreased significantly from 12 weeks to 16 weeks. Giemsa surface staining and SEM showed that G2B1 contacted bone directly without intervening soft tissue in the specimens at each time point, while there was always a soft tissue layer between CMW1 and bone. The results indicate that G2B1 has excellent bioactivity.
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40

Burt, Lauren A., John D. Schipilow, and Steven K. Boyd. "Competitive trampolining influences trabecular bone structure, bone size, and bone strength." Journal of Sport and Health Science 5, no. 4 (December 2016): 469–75. http://dx.doi.org/10.1016/j.jshs.2015.01.007.

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41

Hernandez, C. J. "How can bone turnover modify bone strength independent of bone mass?" Bone 42, no. 6 (June 2008): 1014–20. http://dx.doi.org/10.1016/j.bone.2008.02.001.

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42

Langman, Craig B. "Genetic regulation of bone mass: from bone density to bone strength." Pediatric Nephrology 20, no. 3 (January 5, 2005): 352–55. http://dx.doi.org/10.1007/s00467-004-1687-6.

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43

Vandewalle, S., Y. Taes, M. Van Helvoirt, P. Debode, N. Herregods, C. Ernst, G. Roef, et al. "Bone Size and Bone Strength Are Increased in Obese Male Adolescents." Journal of Clinical Endocrinology & Metabolism 98, no. 7 (July 1, 2013): 3019–28. http://dx.doi.org/10.1210/jc.2012-3914.

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Context: Controversy exists on the effect of obesity on bone development during puberty. Objective: Our objective was to determine differences in volumetric bone mineral density (vBMD) and bone geometry in male obese adolescents (ObAs) in overlap with changes in bone maturation, muscle mass and force development, and circulating sex steroids and IGF-I. We hypothesized that changes in bone parameters are more evident at the weight-bearing site and that changes in serum estradiol are most prominent. Design, Setting, and Participants: We recruited 51 male ObAs (10–19 years) at the entry of a residential weight-loss program and 51 healthy age-matched and 51 bone-age–matched controls. Main Outcome Measures: vBMD and geometric bone parameters, as well as muscle and fat area were studied at the forearm and lower leg by peripheral quantitative computed tomography. Muscle force was studied by jumping mechanography. Results: In addition to an advanced bone maturation, differences in trabecular bone parameters (higher vBMD and larger trabecular area) and cortical bone geometry (larger cortical area and periosteal and endosteal circumference) were observed in ObAs both at the radius and tibia at different pubertal stages. After matching for bone age, all differences at the tibia, but only the difference in trabecular vBMD at the radius, remained significant. Larger muscle area and higher maximal force were found in ObAs compared with controls, as well as higher circulating free estrogen, but similar free testosterone and IGF-I levels. Conclusions: ObAs have larger and stronger bones at both the forearm and lower leg. The observed differences in bone parameters can be explained by a combination of advanced bone maturation, higher estrogen exposure, and greater mechanical loading resulting from a higher muscle mass and strength.
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44

Pujari-Palmer, Michael, Roger Giró, Philip Procter, Alicja Bojan, Gerard Insley, and Håkan Engqvist. "Factors That Determine the Adhesive Strength in a Bioinspired Bone Tissue Adhesive." ChemEngineering 4, no. 1 (March 21, 2020): 19. http://dx.doi.org/10.3390/chemengineering4010019.

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Phosphoserine-modified cements (PMCs) are a family of wet-field tissue adhesives that bond strongly to bone and biomaterials. The present study evaluated variations in the adhesive strength using a scatter plot, failure mode, and a regression analysis of eleven factors. All single-factor, continuous-variable correlations were poor (R2 < 0.25). The linear regression model explained 31.6% of variation in adhesive strength (R2 = 0.316 p < 0.001), with bond thickness predicting an 8.5% reduction in strength per 100 μm increase. Interestingly, PMC adhesive strength was insensitive to surface roughness (Sa 1.27–2.17 μm) and the unevenness (skew) of the adhesive bond (p > 0.167, 0.171, ANOVA). Bone glued in conditions mimicking the operating theatre (e.g., the rapid fixation and minimal fixation force in fluids) produced comparable adhesive strength in laboratory conditions (2.44 vs. 1.96 MPa, p > 0.986). The failure mode correlated strongly with the adhesive strength; low strength PMCs (<1 MPa) failed cohesively, while high strength (>2 MPa) PMCs failed adhesively. Failure occurred at the interface between the amorphous surface layer and the PMC bulk. PMC bonding is sufficient for clinical application, allowing for a wide tolerance in performance conditions while maintaining a minimal bond strength of 1.5–2 MPa to cortical bone and metal surfaces.
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45

Arabmotlagh, Mohammad, Thorsten Hennigs, Joerg Warzecha, and Markus Rittmeister. "Bone Strength Influences Periprosthetic Bone Loss after Hip Arthroplasty." Clinical Orthopaedics and Related Research 440, &NA; (November 2005): 178–83. http://dx.doi.org/10.1097/01.blo.0000176148.39380.ff.

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46

Burr, David B. "Muscle Strength, Bone Mass, and Age-Related Bone Loss." Journal of Bone and Mineral Research 12, no. 10 (October 1, 1997): 1547–51. http://dx.doi.org/10.1359/jbmr.1997.12.10.1547.

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47

Seeman, Ego. "Periosteal Bone Formation — A Neglected Determinant of Bone Strength." New England Journal of Medicine 349, no. 4 (July 24, 2003): 320–23. http://dx.doi.org/10.1056/nejmp038101.

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48

Young, Jesse W., Robert Danczak, Gabrielle A. Russo, and Connie D. Fellmann. "Limb bone morphology, bone strength, and cursoriality in lagomorphs." Journal of Anatomy 225, no. 4 (July 21, 2014): 403–18. http://dx.doi.org/10.1111/joa.12220.

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49

Cure-Cure, C., and P. Cure. "Lactation, bone strength and reduced risk of bone fractures." Osteoporosis International 24, no. 4 (October 5, 2012): 1519. http://dx.doi.org/10.1007/s00198-012-2151-2.

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50

Fonseca, Hélder, Daniel Moreira-Gonçalves, Hans-Joachim Appell Coriolano, and José Alberto Duarte. "Bone Quality: The Determinants of Bone Strength and Fragility." Sports Medicine 44, no. 1 (October 3, 2013): 37–53. http://dx.doi.org/10.1007/s40279-013-0100-7.

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