Objectives:
The ability to determine human bone stiffness is of clinical relevance in many
fields, including bone quality assessment and orthopaedic prosthesis design. Stiffness can
be measured using compression testing; an experimental technique commonly used to test
bone specimens
in vitro.
This systematic review aims to determine how best to perform
compression testing of human bone.
Methods:
A keyword search of all English language articles up until December 2017 of
compression testing of bone was undertaken in Medline, Embase, PubMed and Scopus
databases. Studies using bulk tissue, animal tissue, whole bone or testing techniques other
than compression testing were excluded.
Results:
4712 abstracts were retrieved with a total of 177 papers included in the analysis. 20
studies directly analysed the compression testing technique to improve the accuracy of the
testing technique. Several influencing factors should be considered when testing bone
samples in compression. These include the method of data analysis, specimen storage,
specimen preparation, testing configuration and loading protocol.
Conclusions:
Compression testing is a widely used technique for measuring the stiffness of
bone but there is a great deal of inter-study variation in experimental techniques across the
literature. Based on best evidence from the literature, suggestions for bone compression
testing are made in this review, though further studies are needed to help establish
standardised bone testing techniques to increase the comparability and reliability of bone
stiffness studies.