Does microdamage accumulation affect the mechanical properties of bone?

It has never been demonstrated that microcrack accumulation in bone leads to impaired mechanical properties. We hypothesized that microdamage accumulation is positively and linearly correlated with a reduction in bone's elastic modulus. We also tested the hypothesis that damage accumulates more rapidly in tensile cortices, but crack growth is greater in compressive cortices. Canine femurs (n = 26) were tested in four-point cyclic bending under load control until they had lost between 5 and 43% of their stiffness. Ten femurs were used as nonloaded controls. The loaded portion of the bone was stained en bloc with basic fuchsin to detect the presence of microdamage. The number of stained microcracks, their lengths and the area of damaged bone were measured under the microscope. Crack numerical density, surface density, mean crack length, and the percentage of damaged area were calculated. Significant microdamage accumulation was not detected until the bone had lost 15% of its elastic modulus. The relationship between crack density and stiffness loss was approximately quadratic, but the relationship between damaged area and stiffness loss was linear. There were significantly more microcracks in tensile cortices, but on average cracks were significantly longer in compressive cortices. We conclude that microcrack accumulation impairs the mechanical properties of bone by reducing its elastic modulus. We also conclude that damage accumulates more rapidly in tensile cortices, but crack growth is greater in compressive cortices.