BIOMECHANICAL CHARACTERIZATION OF DIABETIC BONE AND FUTURE DIRECTIONS WITH DECELLULARIZED BONE

According to the World Health Organisation, the number of people living with diabetes has risen from 200 million in 1990 to 830 million in 2022 [1]. An increased risk of bone fracture is associated with diabetes and peripheral neuropathy is reported in nearly 50 % of diabetic patients [2]. In extreme cases this is manifest in Charcot osteoarthropathy, a condition associated with progressive destruction and fracture of bones in the foot and ankle [3]. This has led many researchers to question whether peripheral neuropathy is responsible for altering bone structural properties such as mineral density. Research studies to date have investigated the influence of diabetes on either the bone mineral density or the mechanical properties of bones in the foot. While results been inconclusive, no study has jointly performed structural imaging and mechanical characterisation of bones in diabetic and non-diabetic feet in order to investigate for changes to bone structure-function relationships. The first part of the presentation will discuss the results of a recent study by our group combining micro computed tomography (μCT) imaging and compression testing to characterise calcaneus bone specimens obtained from diabetic and non-diabetic feet. For both test groups, μCT imaging determined structural properties such bone mineral density, bone volume fraction, trabecular thickness, trabecular spacing and trabecular number, while compression testing measured the maximum compressive stress, proof stress and Young's modulus. The second part of the presentation will examine the utility of decellularised biological scaffolds (DBSs) as either a bone substitute or the basis for in-vitro models of diabetes. Bone DBSs possess native tissue-replicating mechanical and biological environments [4], making them ideally suited for use in in-vitro models that simulate biological activity to understand the mechanisms and effects of diseases such as diabetes (e.g. changes to bone structure-function relationships). Such models could replace ineffective and expensive live animal models. Our group has recently innovated a successful decellularisation protocol, substantially reducing the process time allowing quicker product turnaround. This enables a more readily available platform of DBSs, which can be repopulated with cells in a controlled manner to trigger diseases and create models with advanced human tissue mimicry..