Improved Prediction Of Proximal Femoral Fracture Load Using Nonlinear Finite Element Models.
Published 2001 · Engineering, Medicine
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Hip fracture, which is often due to osteoporosis or other conditions affecting bone strength, can lead to permanent disability, pneumonia, pulmonary embolism, and/or death. Great effort has been directed toward developing noninvasive methods for evaluating proximal femoral strength (fracture load), with the goal of assessing fracture risk. Previously, computed tomographic scan-based, linear finite element (FE) models were used to estimate proximal femoral fracture loads ex vivo in two load configurations, one approximating joint loading during single-limb stance and the other simulating impact from a fall. Measured and computed fracture loads were correlated (stance, r=0.867; fall, r=0.949). However, precision for the stance configuration was insufficient to identify subjects with below average fracture loads reliably. The present study examined whether, for this configuration, nonlinear FE models could be used to identify these subjects. These models were found to predict fracture load within +/-2.0 kN (r=0.962). This level of precision is sufficient to identify 97.5% of femora with fracture loads 1.3 standard deviations below the mean as having below average fracture loads. Accordingly, 20% of subjects with below average fracture loads, i.e. those with the lowest fracture loads and likely to be at greatest risk of fracture, would be correctly identified with at least 97.5% reliability. This FE modeling method will be a powerful tool for studies of hip fracture.
This paper references
Volumetric quantitative computed tomography of the proximal femur: precision and relation to bone strength.
T. Lang (1997)
A cellular solid criterion for predicting the axial-shear failure properties of bovine trabecular bone.
C. Fenech (1999)
Musculoskeletal conditions in the United States
Allan Praemer (1992)
Fractured neck of the femur: the cause of the fall?
J. Sloan (1981)
Predicting femoral neck strength from bone mineral data. A structural approach.
T. J. Beck (1990)
Fracture prediction for the proximal femur using finite element models: Part I--Linear analysis.
J. C. Lotz (1991)
AN EPIDEMIOLOGIC STUDY OF CERVICAL AND TROCHANTERIC FRACTURES OF THE FEMUR IN AN URBAN POPULATION. ANALYSIS OF 1,664 CASES WITH SPECIAL REFERENCE TO ETIOLOGIC FACTORS.
P. Alffram (1964)
Mechanical Engineering Design.
J. E. Shigley (1972)
Costs and health effects of osteoporotic fractures.
E. Chrischilles (1994)
Bone mineral content and mechanical strength. An ex vivo study on human femora at autopsy.
A. Alho (1988)
Effect of local density changes on the failure load of the proximal femur.
Z. M. Oden (1999)
Medical Expenditures for the Treatment of Osteoporotic Fractures in the United States in 1995: Report from the National Osteoporosis Foundation
N. F. Ray (1997)
Age-related reductions in the strength of the femur tested in a fall-loading configuration.
A. Courtney (1995)
Estimation of material properties in the equine metacarpus with use of quantitative computed tomography.
C. Les (1994)
Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences
J. Cohen (1976)
Evaluation of orthogonal mechanical properties and density of human trabecular bone from the major metaphyseal regions with materials testing and computed tomography.
M. Ciarelli (1991)
Prediction of femoral fracture load using finite element models: an examination of stress- and strain-based failure theories.
J. Keyak (2000)
Spontaneous fractures of the hip in the elderly.
T. Horiuchi (1988)
The effect of impact direction on the structural capacity of the proximal femur during falls
C. M. Ford (1996)
Predicting the compressive mechanical behavior of bone.
T. Keller (1994)
Density predicts the activity-dependent failure load of proximal femora with defects
D. Michaeli (1999)
Postfailure compressive behavior of tibial trabecular bone in three anatomic directions.
J. Keyak (1996)
The Femoral Neck. Function, Fracture Mechanism, Internal Fixation. An experimental study. By
V. Frankel (1960)
Correlations between orthogonal mechanical properties and density of trabecular bone: use of different densitometric measures.
J. Keyak (1994)
Femoral strength is better predicted by finite element models than QCT and DXA.
D. Cody (1999)
The elastic and ultimate properties of compact bone tissue.
D. Reilly (1975)
Prediction of femoral fracture load using automated finite element modeling.
J. Keyak (1997)
The use of quantitative computed tomography to estimate risk of fracture of the hip from falls.
J. C. Lotz (1990)
Detailed diagnoses and procedures, National Hospital Discharge Survey, 1997.
M. Owings (1999)
Automated three-dimensional finite element modelling of bone: a new method.
J. Keyak (1990)
Elastic and inelastic stress analysis
Irving H. Shames (1997)
Biomechanical properties of the proximal femur determined in vitro by single‐energy quantitative computed tomography
S. Esses (1989)
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X-Ray Based Imaging Methods to Assess Bone Quality
Klaus Engelke (2014)
The influence of the modulus-density relationship and the material mapping method on the simulated mechanical response of the proximal femur in side-ways fall loading configuration.
B. Helgason (2016)
Inhomogeneous material property assignment and orientation definition of transverse isotropy of femur
Haisheng Yang (2009)
Comparison of Buckling Ratio and Finite Element Analysis of Femoral Necks in Post-menopausal Women
D. Anitha (2014)
Development of finite element analysis of magnetic resonance elastography to investigate its potential use in abdominal aortic aneurysms
L. Hollis (2016)
Robust QCT/FEA Models of Proximal Femur Stiffness and Fracture Load During a Sideways Fall on the Hip
D. Dragomir-Daescu (2010)
Insights into the effects of tensile and compressive loadings on microstructure dependent fracture of trabecular bone
V. Tomar (2009)
Patient specific quantitative analysis of fracture fixation in the proximal femur implementing principal strain ratios. Method and experimental validation.
Eran Peleg (2010)
Using visual image measurements to validate a novel finite element model of crack propagation and fracture patterns of proximal femur
Awad Bettamer (2017)
An anatomical subject-specific FE-model for hip fracture load prediction
L. Duchemin (2008)
Comparison of 3D finite element analysis derived stiffness and BMD to determine the failure load of the excised proximal femur.
C. Langton (2009)
Osseointegrated system for fixation of upper leg protheses
P. Tomaszewski (2012)
Influence of geometry on proximal femoral shaft strains: Implications for atypical femoral fracture.
Ifaz T Haider (2018)
Biomechanical modeling of proximal femur : development of finite element models to simulate fractures
Janne Koivumäki (2013)
A shape analysis approach to prediction of bone stiffness using FEXI
S. Pisharody (2007)
Simulation of hip fracture in sideways fall using a 3D finite element model of pelvis-femur-soft tissue complex with simplified representation of whole body.
S. Majumder (2007)
Patient-Specific Bone Multiscale Modelling, Fracture Simulation and Risk Analysis—A Survey
Amadeus C S de Alcântara (2019)
Physical Activity for Strengthening Fracture Prone Regions of the Proximal Femur
R. Fuchs (2017)
Dual Energy X-Ray Absorptiometry
Abdellah El Maghraoui (2012)
Numerical Investigation of Knee–Thigh–Hip Injuries in Frontal Vehicle Collisions
Douglas R. Heath (2012)
Individual and combined effects of OA-related subchondral bone alterations on proximal tibial surface stiffness: a parametric finite element modeling study.
Morteza Amini (2015)
Finite element analysis of the femoral diaphysis of fresh-frozen cadavers with computed tomography and mechanical testing
Yasushi Wako (2018)
Comparative Study of Femur Bone Having Different Boundary Conditions and Bone Structure Using Finite Element Method
Kishanchand Chethan (2018)
Low-dose and sparse sampling MDCT-based femoral bone strength prediction using finite element analysis
N. M. Rayudu (2020)
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)
Nonlinear voxel-based finite element model for strength assessment of healthy and metastatic proximal femurs
A. Sas (2020)
Patient-specific modelling of bone and bone-implant systems: the challenges.
P. Pankaj (2013)
Lytic lesions in the femoral neck: Importance of location and evaluation of a novel minimally invasive repair technique.
T. S. Kaneko (2008)
Hip fracture risk estimation based on bone mineral density of a biomechanically guided region of interest: a preliminary study
W. Li (2008)
Trabecular Bone Analysis in CT and X-Ray Images of the Proximal Femur for the Assessment of Local Bone Quality
Karl D. Fritscher (2009)
Combined musculoskeletal dynamics/structural finite element analysis of femur physiological loads during walking
David W. Wagner (2010)
Proximal femur bone strength estimated by a computationally fast finite element analysis in a sideways fall configuration.
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