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@article{Arnold:2017:10.1302/2046-3758.69.BJR-2016-0317.R2,
author = {Arnold, M and Zhao, S and Ma, S and Giuliani, F and Hansen, U and Cobb, JP and Abel, RL and Boughton, OR},
doi = {10.1302/2046-3758.69.BJR-2016-0317.R2},
journal = {Bone & Joint Research},
pages = {542--549},
title = {Microindentation: a tool for measuring cortical bone stiffness? A systematic review},
url = {http://dx.doi.org/10.1302/2046-3758.69.BJR-2016-0317.R2},
volume = {6},
year = {2017}
}

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TY  - JOUR
AB  - Objectives: Microindentation hasthe potential to measuretheelasticity(stiffness)of individualpatients’bone.  Bone  elasticity  plays  a  crucial  role  in  the  press-fit  stability  of  orthopaedic implants.Arming  surgeons  with  accuratebone  elasticityinformation may  reduce  surgical complicationsincluding  peri-prosthetic fractures. The question we address with this systematicreview is whether microindentation can accurately measure cortical bone stiffness.Methods: A  systematic  review  of  all  English language articles  using  a  keyword  search  was undertaken in Medline, Embase, PubMed, Scopus and Cochrane databases. Studies thatonly used nanoindentation, cancellous boneoranimal tissue were excluded.Results: 1094abstracts  were  retrieved  and 32papers  were  included  in  the  analysis,  20  of which  used  reference  point  indentation  and  12of which  used  traditional  depth  sensing indentation.There  are  a  number  of  factors thatmust  be  taken  into  account  when  using microindentation  such  as  tip  size,  depth  and  method  of  analysis.Only two  studies validated microindentation againsttraditional mechanical testing techniques. Bothstudies used reference point  indentation(RPI) with  one  showing  that RPI  parameters  correlate  well  with  mechanical testing, butanother suggestedthatthey do not. Conclusion: Microindentation has  been  used  in  various  studies  to  assess  bone  elasticity  but only  two  studies  with  conflicting  results  compared  microindentation  to  traditional  mechanical testing  techniques. Further  research,includingmore  studies  comparingmicroindentationto other mechanical testing methodsare needed,before microindentation can be reliably used to calculate cortical bone stiffness.
AU  - Arnold,M
AU  - Zhao,S
AU  - Ma,S
AU  - Giuliani,F
AU  - Hansen,U
AU  - Cobb,JP
AU  - Abel,RL
AU  - Boughton,OR
DO  - 10.1302/2046-3758.69.BJR-2016-0317.R2
EP  - 549
PY  - 2017///
SN  - 2046-3758
SP  - 542
TI  - Microindentation: a tool for measuring cortical bone stiffness? A systematic review
T2  - Bone & Joint Research
UR  - http://dx.doi.org/10.1302/2046-3758.69.BJR-2016-0317.R2
UR  - http://hdl.handle.net/10044/1/49906
VL  - 6
ER  -

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