Online citations, reference lists, and bibliographies.

Assessment Of Incident Spine And Hip Fractures In Women And Men Using Finite Element Analysis Of CT Scans

D. Kopperdahl, T. Aspelund, P. F. Hoffmann, S. Sigurdsson, K. Siggeirsdottir, T. Harris, V. Gudnason, T. M. Keaveny
Published 2014 · Medicine, Biology

Cite This
Download PDF
Analyze on Scholarcy
Share
Finite element analysis of computed tomography (CT) scans provides noninvasive estimates of bone strength at the spine and hip. To further validate such estimates clinically, we performed a 5‐year case‐control study of 1110 women and men over age 65 years from the AGES‐Reykjavik cohort (case = incident spine or hip fracture; control = no incident spine or hip fracture). From the baseline CT scans, we measured femoral and vertebral strength, as well as bone mineral density (BMD) at the hip (areal BMD only) and lumbar spine (trabecular volumetric BMD only). We found that for incident radiographically confirmed spine fractures (n = 167), the age‐adjusted odds ratio for vertebral strength was significant for women (2.8, 95% confidence interval [CI] 1.8 to 4.3) and men (2.2, 95% CI 1.5 to 3.2) and for men remained significant (p = 0.01) independent of vertebral trabecular volumetric BMD. For incident hip fractures (n = 171), the age‐adjusted odds ratio for femoral strength was significant for women (4.2, 95% CI 2.6 to 6.9) and men (3.5, 95% CI 2.3 to 5.3) and remained significant after adjusting for femoral neck areal BMD in women and for total hip areal BMD in both sexes; fracture classification improved for women by combining femoral strength with femoral neck areal BMD (p = 0.002). For both sexes, the probabilities of spine and hip fractures were similarly high at the BMD‐based interventional thresholds for osteoporosis and at corresponding preestablished thresholds for “fragile bone strength” (spine: women ≤ 4500 N, men ≤ 6500 N; hip: women ≤ 3000 N, men ≤ 3500 N). Because it is well established that individuals over age 65 years who have osteoporosis at the hip or spine by BMD criteria should be considered at high risk of fracture, these results indicate that individuals who have fragile bone strength at the hip or spine should also be considered at high risk of fracture. © 2014 American Society for Bone and Mineral Research.
This paper references
10.7326/0003-4819-122-7-199504010-00024
Reviews and Notes: Assessment of Fracture Risk and Its Application to Screening for Postmenopausal Osteoporosis
L. Alexeeva (1994)
10.1359/jbmr.070728
Structural Determinants of Vertebral Fracture Risk
L. J. Melton (2007)
10.1016/J.JBIOMECH.2007.09.009
Subject-specific finite element models implementing a maximum principal strain criterion are able to estimate failure risk and fracture location on human femurs tested in vitro.
E. Schileo (2008)
10.1016/S0736-0266(01)00185-1
Quantitative computed tomography estimates of the mechanical properties of human vertebral trabecular bone.
D. Kopperdahl (2002)
10.1002/JBMR.5650040218
Models of spinal trabecular bone loss as determined by quantitative computed tomography
J. Block (1989)
10.1148/radiology.179.3.2027972
Effect of bone distribution on vertebral strength: assessment with patient-specific nonlinear finite element analysis.
K. Faulkner (1991)
10.1093/AJE/KWH101
Limitations of the odds ratio in gauging the performance of a diagnostic, prognostic, or screening marker.
M. Pepe (2004)
10.1016/j.ejrad.2010.02.008
Phantom-less QCT BMD system as screening tool for osteoporosis without additional radiation.
D. Mueller (2011)
10.1002/SIM.2929
Evaluating the added predictive ability of a new marker: from area under the ROC curve to reclassification and beyond.
M. J. Pencina (2008)
10.1359/jbmr.070608
Identification of Vertebral Fracture and Non‐Osteoporotic Short Vertebral Height in Men: The MrOS Study
L. Ferrar (2007)
10.1115/1.2794186
Dynamic models for sideways falls from standing height.
A. J. van den Kroonenberg (1995)
10.1007/s00198-007-0343-y
The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women
J. Kanis (2007)
10.1016/J.JBIOMECH.2006.08.003
Prediction of strength and strain of the proximal femur by a CT-based finite element method.
M. Bessho (2007)
10.1016/j.bone.2008.08.106
International Society for Clinical Densitometry 2007 Adult and Pediatric Official Positions.
E. Lewiecki (2008)
10.1016/8756-3282(85)90399-0
Quantitative computed tomography for prediction of vertebral fracture risk.
C. Cann (1985)
10.1359/jbmr.091033
Age-Dependence of Femoral Strength in White Women and Men
T. M. Keaveny (2010)
10.1016/J.BONE.2006.10.025
Comparison of quantitative computed tomography-based measures in predicting vertebral compressive strength.
J. Buckley (2007)
10.1016/j.bone.2012.10.036
High resolution quantitative computed tomography-based assessment of trabecular microstructure and strength estimates by finite-element analysis of the spine, but not DXA, reflects vertebral fracture status in men with glucocorticoid-induced osteoporosis.
C. Graeff (2013)
10.1097/BRS.0b013e31815e3993
In Vivo Assessment of Lumbar Vertebral Strength in Elderly Women Using Computed Tomography-Based Nonlinear Finite Element Model
K. Imai (2008)
10.1359/jbmr.081201
Finite Element Analysis of the Proximal Femur and Hip Fracture Risk in Older Men
E. Orwoll (2009)
10.1016/j.jocd.2007.12.010
Clinical use of quantitative computed tomography and peripheral quantitative computed tomography in the management of osteoporosis in adults: the 2007 ISCD Official Positions.
K. Engelke (2008)
10.1007/s001980170072
An Assessment Tool for Predicting Fracture Risk in Postmenopausal Women
D. Black (2001)
10.1359/jbmr.081244
A Simple Risk Score for the Assessment of Absolute Fracture Risk in General Practice Based on Two Longitudinal Studies
S. Pluijm (2009)
10.1016/j.bone.2012.09.006
A nonlinear QCT-based finite element model validation study for the human femur tested in two configurations in vitro.
E. Dallara (2013)
10.1002/jbmr.347
Association of hip strength estimates by finite‐element analysis with fractures in women and men
S. Amin (2011)
10.1007/s00198-008-0750-8
Assessment of vertebral fracture risk and therapeutic effects of alendronate in postmenopausal women using a quantitative computed tomography-based nonlinear finite element method
K. Imai (2008)
10.1016/j.bone.2007.11.001
A reference standard for the description of osteoporosis.
J. Kanis (2008)
10.1016/S1350-4533(01)00045-5
Improved prediction of proximal femoral fracture load using nonlinear finite element models.
J. Keyak (2001)
10.1111/j.1749-6632.2009.05348.x
Biomechanical computed tomography-noninvasive bone strength analysis using clinical computed tomography scans.
T. M. Keaveny (2010)
10.1359/jbmr.060606
Age‐ and Sex‐Specific Differences in the Factor of Risk for Vertebral Fracture: A Population‐Based Study Using QCT
M. Bouxsein (2006)
10.1002/jbmr.428
Simultaneous screening for osteoporosis at CT colonography: Bone mineral density assessment using MDCT attenuation techniques compared with the DXA reference standard
Perry J Pickhardt (2011)
10.1016/J.BONE.2009.01.158
Prediction of femoral strength in a sideways fall configuration using QCT-based finite element analysis
B. Roberts (2009)
10.1002/jbmr.189
Estimating bisphosphonate use and fracture reduction among US women aged 45 years and older, 2001–2008
E. Siris (2011)
10.1097/RCT.0b013e3182032537
Feasibility of Simultaneous Computed Tomographic Colonography and Fully Automated Bone Mineral Densitometry in a Single Examination
R. Summers (2011)
10.1007/s00198-011-1568-3
QCT-based finite element models predict human vertebral strength in vitro significantly better than simulated DEXA
E. Dall’Ara (2011)
10.1002/jbmr.150
Relation of Vertebral Deformities to Bone Density, Structure, and Strength
L. J. Melton (2010)
10.1016/j.bone.2012.01.012
Ct-based finite element models can be used to estimate experimentally measured failure loads in the proximal femur.
Janne E. M. Koivumäki (2012)
10.1016/S8756-3282(03)00210-2
Finite element models predict in vitro vertebral body compressive strength better than quantitative computed tomography.
R. Crawford (2003)
10.1002/JBMR.5650080915
Vertebral fracture assessment using a semiquantitative technique
H. Genant (1993)
10.1002/jbmr.1539
Prediction of new clinical vertebral fractures in elderly men using finite element analysis of CT scans
Xiang Wang (2012)
10.1007/s001980050093
Updated Data on Proximal Femur Bone Mineral Levels of US Adults
A. Looker (1998)
10.1001/archinternmed.2009.440
Projected cancer risks from computed tomographic scans performed in the United States in 2007.
A. Berrington de González (2009)
10.1007/s10654-007-9163-9
Inaccuracy in self-report of fractures may underestimate association with health outcomes when compared with medical record based fracture registry
K. Siggeirsdottir (2007)
10.1002/jbmr.2033
Microstructural Failure Mechanisms in the Human Proximal Femur for Sideways Fall Loading
S. Nawathe (2014)
10.1007/s00198-008-0820-y
Comparison of QCT-derived and DXA-derived areal bone mineral density and T scores
B. C. C. Khoo (2008)
10.1377/hlthaff.2011.0233
Medicare payment cuts for osteoporosis testing reduced use despite tests' benefit in reducing fractures.
A. B. King (2011)
10.1016/j.bone.2011.03.682
Male-female differences in the association between incident hip fracture and proximal femoral strength: a finite element analysis study.
J. Keyak (2011)
Development of a model to predict the compressive forces on the spine associated with age-related vertebral fractures
S. Wilson (1994)
10.1093/AJE/KWK115
Age, Gene/Environment Susceptibility-Reykjavik Study: multidisciplinary applied phenomics.
T. Harris (2007)
10.1002/jbmr.1580
More bone density testing is needed, not less
E. Lewiecki (2012)



This paper is referenced by
10.1002/jbmr.2552
Predicting Hip Fracture Type With Cortical Bone Mapping (CBM) in the Osteoporotic Fractures in Men (MrOS) Study
Graham M. Treece (2015)
10.18203/2349-3259.IJCT20161408
In silico clinical trials: how computer simulation will transform the biomedical industry
M. Viceconti (2016)
10.1139/cjpp-2019-0249
Adverse plasma fatty acid composition in patients with femoral neck fracture.
A. Arsić (2019)
10.1007/978-3-319-30412-0_13
What’s Next in the Field of Bone Health in Pediatrics? Research Considerations
Sharmila Majumdar (2016)
10.1007/s11914-018-0438-8
Are CT-Based Finite Element Model Predictions of Femoral Bone Strengthening Clinically Useful?
M. Viceconti (2018)
10.1016/j.bone.2020.115321
Hip load capacity and yield load in men and women of all ages.
Joyce H. Keyak (2020)
10.1007/s11914-018-0450-z
Fracture Prediction by Computed Tomography and Finite Element Analysis: Current and Future Perspectives
Fjóla Jóhannesdóttir (2018)
10.1007/s40520-019-01294-4
Radiofrequency echographic multi-spectrometry for the in-vivo assessment of bone strength: state of the art—outcomes of an expert consensus meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO)
Adolfo Diez-Perez (2019)
10.1002/9781119266594.CH36
Reference Point Indentation
A. Diez-Perez (2018)
10.1177/2192568219889362
Opportunistic Computed Tomography and Spine Surgery: A Narrative Review
Matthew Shirley (2020)
Can 3D measurements obtained by lumbar DXA predict fractures in the dorsal vertebrae?
Mirella López Picazo (2020)
Evaluación de la afectación ósea en el paciente infectado por el virus de la inmunodeficiencia humana
Daniel Morant (2017)
10.1016/j.jmbbm.2016.07.004
Can CT image deblurring improve finite element predictions at the proximal femur?
Cristina Falcinelli (2016)
10.1007/s11657-017-0412-6
The QUALYOR (QUalité Osseuse LYon Orléans) study: a new cohort for non invasive evaluation of bone quality in postmenopausal osteoporosis. Rationale and study design
Roland D. Chapurlat (2017)
10.1016/j.jmbbm.2019.01.014
Mechanical behavior of metastatic femurs through patient-specific computational models accounting for bone-metastasis interaction.
Cristina Falcinelli (2019)
10.1002/jbmr.3423
Osteoporosis and Hip Fracture Risk From Routine Computed Tomography Scans: The Fracture, Osteoporosis, and CT Utilization Study (FOCUS)
A. Adams (2018)
comprehensive assessment of Osteoporosis and Bone Fragility
Jeff L. Fidler (2016)
10.1007/s00198-018-4716-1
Prediction of incident vertebral fracture using CT-based finite element analysis
B. Allaire (2018)
10.1007/s11012-019-01097-x
Fracture risk assessment in metastatic femurs: a patient-specific CT-based finite-element approach
Cristina Falcinelli (2020)
10.1007/S10409-019-00855-0
Single-leg weight limit of fixation model of simple supracondylar fracture of femur
Guo-Yu Bai (2019)
10.1016/j.jot.2015.08.006
Quantitative computed tomography and opportunistic bone density screening by dual use of computed tomography scans
A. Brett (2015)
10.1016/j.bone.2017.07.023
Comparison of non-invasive assessments of strength of the proximal femur.
F. Johannesdottir (2017)
10.1016/j.bone.2020.115227
MRI-based assessment of proximal femur strength compared to mechanical testing.
C. Rajapakse (2020)
10.1016/j.medengphy.2018.06.004
Mapping anisotropy improves QCT-based finite element estimation of hip strength in pooled stance and side-fall load configurations.
J. Panyasantisuk (2018)
10.1016/j.jbiomech.2014.12.017
Towards clinical application of biomechanical tools for the prediction of fracture risk in metastatic bone disease.
L. Derikx (2015)
10.2147/IJWH.S112621
Bone strength and management of postmenopausal fracture risk with antiresorptive therapies: considerations for women’s health practice
Angela M W Cheung (2016)
10.1097/RCT.0000000000000788
Effect of Statistically Iterative Image Reconstruction on Vertebral Bone Strength Prediction Using Bone Mineral Density and Finite Element Modeling: A Preliminary Study
D. Anitha (2019)
10.1002/jbmr.2830
Finite Element Analysis of Denosumab Treatment Effects on Vertebral Strength in Ovariectomized Cynomolgus Monkeys
D. Lee (2016)
10.1016/j.bone.2013.12.034
The fragile elderly hip: Mechanisms associated with age-related loss of strength and toughness☆
J. Reeve (2014)
10.1016/j.cmpb.2017.11.007
Fully automated segmentation of a hip joint using the patient-specific optimal thresholding and watershed algorithm
Jung Jin Kim (2018)
10.1002/jor.23524
Incorporation of CT‐based measurements of trunk anatomy into subject‐specific musculoskeletal models of the spine influences vertebral loading predictions
A. Bruno (2017)
10.1016/j.jmbbm.2019.103585
The use of μCT and fractal dimension for fracture prediction in osteoporotic individuals.
Emily L Arnold (2020)
See more
Semantic Scholar Logo Some data provided by SemanticScholar