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Effect of Diabetes Mellitus on the Material Properties of the Distal Tibia

John G. Fleischli, DPM ^*, Terese J. Laughlin, DPM ^*, Kyriacos Athanasiou, PhD, PE , Dan R. Lanctot, MS , Lawrence Lavery, DPM, MPH , Xiaodu Wang, PhD ^|| and C. Mauli Agrawal, PhD, PE 

^* Foot & Ankle Associates of Central Illinois LLC, Jacksonville.
Department of Bioengineering–MS 142, Rice University, Houston, TX.
Department of Orthopaedics, Bioengineering, The University of Texas Health Science Center at San Antonio, San Antonio.
Department of Surgery, Texas A&M University, Temple.
^|| College of Engineering, University of Texas at San Antonio, San Antonio.

Corresponding author: John G. Fleischli, DPM, Foot & Ankle Associates of Central Illinois LLC, 1515 W Walnut, Bldg 12, Jacksonville, IL 62650.

Abstract

This investigation evaluates the effects of diabetes on the mechanical properties of human bone, specifically, the tibia. Seven diabetic and seven nondiabetic human (male) cadaveric distal tibiae were used in this study. The average age of the diabetic cadaveric samples was 51 years (range, 46–61 years), and the average age of the nondiabetic cadaveric samples was 75 years (range, 67–85 years). Three-point bending tests for strength and stiffness were performed on a small sample of each distal tibia. Each specimen was loaded at a constant rate until failure. From the recorded curve of load versus displacement, the ultimate and yield strength of bone and the bending modulus of bone were calculated. The diabetic samples were generally weaker than the older, nondiabetic samples, but no statistically significant differences were found in the elastic modulus (P = .29), yield strength (P = .90), ultimate strength (P = .46), and fracture toughness (P = .78), leading to speculation that diabetes has an effect similar to that of aging on the musculoskeletal system. (J Am Podiatr Med Assoc 96(2): 91–95, 2006)