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Mapping Anisotropy Improves QCT-based Finite Element Estimation Of Hip Strength In Pooled Stance And Side-fall Load Configurations.

J. Panyasantisuk, E. Dall’Ara, M. Pretterklieber, D. Pahr, P. Zysset
Published 2018 · Medicine, Biology

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Hip fractures are one of the most severe consequences of osteoporosis. Compared to the clinical standard of DXA-based aBMD at the femoral neck, QCT-based FEA delivers a better surrogate of femoral strength and gains acceptance for the calculation of hip fracture risk when a CT reconstruction is available. Isotropic, homogenised voxel-based, finite element (hvFE) models are widely used to estimate femoral strength in cross-sectional and longitudinal clinical studies. However, fabric anisotropy is a classical feature of the architecture of the proximal femur and the second determinant of the homogenised mechanical properties of trabecular bone. Due to the limited resolution, fabric anisotropy cannot be derived from clinical CT reconstructions. Alternatively, fabric anisotropy can be extracted from HR-pQCT images of cadaveric femora. In this study, fabric anisotropy from HR-pQCT images was mapped onto QCT-based hvFE models of 71 human proximal femora for which both HR-pQCT and QCT images were available. Stiffness and ultimate load computed from anisotropic hvFE models were compared with previous biomechanical tests in both stance and side-fall configurations. The influence of using the femur-specific versus a mean fabric distribution on the hvFE predictions was assessed. Femur-specific and mean fabric enhance the prediction of experimental ultimate force for the pooled, i.e. stance and side-fall, (isotropic: r2=0.81, femur-specific fabric: r2=0.88, mean fabric: r2=0.86,p<0.001) but not for the individual configurations. Fabric anisotropy significantly improves bone strength prediction for the pooled configurations, and mapped fabric provides a comparable prediction to true fabric. The mapping of fabric anisotropy is therefore expected to help generate more accurate QCT-based hvFE models of the proximal femur for personalised or multiple load configurations.
This paper references
Biomechanical Role of Bone Anisotropy Estimated on Clinical CT Scans by Image Registration
E. Taghizadeh (2016)
Patient-specific finite element estimated femur strength as a predictor of the risk of hip fracture: the effect of methodological determinants
M. Qasim (2016)
Robust QCT/FEA Models of Proximal Femur Stiffness and Fracture Load During a Sideways Fall on the Hip
D. Dragomir-Daescu (2010)
Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study.
S. C. Schuit (2004)
Prediction of Hip Failure Load: In Vitro Study of 80 Femurs Using Three Imaging Methods and Finite Element Models-The European Fracture Study (EFFECT).
P. Pottecher (2016)
A review of morphology-elasticity relationships in human trabecular bone: theories and experiments.
P. Zysset (2003)
To what extent can linear finite element models of human femora predict failure under stance and fall loading configurations?
E. Schileo (2014)
Ten-year risk of osteoporotic fracture and the effect of risk factors on screening strategies.
J. Kanis (2002)
Independent measurement of femoral cortical thickness and cortical bone density using clinical CT
Graham M. Treece (2015)
Assessment of Transverse Isotropy in Clinical-Level CT Images of Trabecular Bone Using the Gradient Structure Tensor
D. Larsson (2014)
Femoral Bone Strength and Its Relation to Cortical and Trabecular Changes After Treatment With PTH, Alendronate, and Their Combination as Assessed by Finite Element Analysis of Quantitative CT Scans
T. M. Keaveny (2008)
Clinical versus pre-clinical FE models for vertebral body strength predictions.
D. Pahr (2014)
NIH Image to ImageJ: 25 years of image analysis
C. Schneider (2012)
Proximal femur bone strength estimated by a computationally fast finite element analysis in a sideways fall configuration.
K. Nishiyama (2013)
BoneJ: Free and extensible bone image analysis in ImageJ.
M. Doube (2010)
Prediction of strength and strain of the proximal femur by a CT-based finite element method.
M. Bessho (2007)
Statistical analysis of the inter-individual variations of the bone shape, volume fraction and fabric and their correlations in the proximal femur.
E. Taghizadeh (2017)
Mapping anisotropy of the proximal femur for enhanced image based finite element analysis.
W. S. Enns-Bray (2014)
Direct mechanics assessment of elastic symmetries and properties of trabecular bone architecture.
B. van Rietbergen (1996)
Multi-axial mechanical properties of human trabecular bone
Liliana Rincón-Kohli (2009)
Bone Volume Fraction and Fabric Anisotropy Are Better Determinants of Trabecular Bone Stiffness Than Other Morphological Variables
G. Maquer (2015)
Improved prediction of proximal femoral fracture load using nonlinear finite element models.
J. Keyak (2001)
Characterization of microstructural anisotropy in orthotropic materials using a second rank tensor
T. Harrigan (1984)
Morphology based anisotropic finite element models of the proximal femur validated with experimental data.
W. Enns-Bray (2016)
Not only stiffness, but also yield strength of the trabecular structure determined by non-linear µFE is best predicted by bone volume fraction and fabric tensor.
Sarah N Musy (2017)
elastix: A Toolbox for Intensity-Based Medical Image Registration
S. Klein (2010)
A novel registration-based methodology for prediction of trabecular bone fabric from clinical QCT: A comprehensive analysis
V. Chandran (2017)
Assessment of incident spine and hip fractures in women and men using finite element analysis of CT scans
D. Kopperdahl (2014)
Accuracy of finite element predictions in sideways load configurations for the proximal human femur.
L. Grassi (2012)
Prediction of femoral fracture load using automated finite element modeling.
J. Keyak (1998)
Orthotropic HR-pQCT-based FE models improve strength predictions for stance but not for side-way fall loading compared to isotropic QCT-based FE models of human femurs.
B. Luisier (2014)
Ct-based finite element models can be used to estimate experimentally measured failure loads in the proximal femur.
Janne E. M. Koivumäki (2012)
Repeat Low‐Trauma Fractures Occur Frequently Among Men and Women Who Have Osteopenic BMD
L. Langsetmo (2009)
Prediction of Trabecular Bone Anisotropy from Quantitative Computed Tomography Using Supervised Learning and a Novel Morphometric Feature Descriptor
V. Chandran (2015)
How accurately can we predict the fracture load of the proximal femur using finite element models?
Sven van den Munckhof (2014)
Validation of an automated method of three-dimensional finite element modelling of bone.
J. Keyak (1993)
Limitations of the continuum assumption in cancellous bone.
T. Harrigan (1988)
An Alternative Fabric-based Yield and Failure Criterion for Trabecular Bone
P. Zysset (2006)
Tests for comparing elements of a correlation matrix.
J. Steiger (1980)
Femoral strength is better predicted by finite element models than QCT and DXA.
D. Cody (1999)
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)
Comparison of proximal femur and vertebral body strength improvements in the FREEDOM trial using an alternative finite element methodology.
P. Zysset (2015)
A novel approach to estimate trabecular bone anisotropy using a database approach.
J. Hazrati Marangalou (2013)
Morphology–elasticity relationships using decreasing fabric information of human trabecular bone from three major anatomical locations
Thomas Groß (2013)
Influence of boundary conditions on computed apparent elastic properties of cancellous bone
D. Pahr (2008)
A three-dimensional elastic plastic damage constitutive law for bone tissue
D. García (2009)
An anatomical subject-specific FE-model for hip fracture load prediction
L. Duchemin (2008)
Patient-Specific Biomechanical Modeling of Bone Strength Using Statistically-Derived Fabric Tensors
K. Lekadir (2015)
HR-pQCT-based homogenised finite element models provide quantitative predictions of experimental vertebral body stiffness and strength with the same accuracy as μFE models
D. Pahr (2012)
Integrated remodeling-to-fracture finite element model of human proximal femur behavior.
R. Hambli (2013)
Estimation of the effective yield properties of human trabecular bone using nonlinear micro-finite element analyses
Patrik Wili (2017)
A nonlinear QCT-based finite element model validation study for the human femur tested in two configurations in vitro.
E. Dallara (2013)
Clinical Use of Quantitative Computed Tomography-Based Finite Element Analysis of the Hip and Spine in the Management of Osteoporosis in Adults: the 2015 ISCD Official Positions-Part II.
P. Zysset (2015)
The quantitative morphology of anisotropic trabecular bone
W. Whitehouse (1974)
Effect of boundary conditions on yield properties of human femoral trabecular bone
J. Panyasantisuk (2016)
A new approach to determine the accuracy of morphology-elasticity relationships in continuum FE analyses of human proximal femur.
J. Hazrati Marangalou (2012)
Measurement of structural anisotropy in femoral trabecular bone using clinical-resolution CT images.
M. Kersh (2013)
Comparison of non-invasive assessments of strength of the proximal femur.
F. Johannesdottir (2017)
Clinical Use of Quantitative Computed Tomography (QCT) of the Hip in the Management of Osteoporosis in Adults: the 2015 ISCD Official Positions-Part I.
K. Engelke (2015)
Cortical Bone Thickness Estimation in CT Images: A Model-Based Approach Without Profile Fitting
Oleg Museyko (2015)
Automated finite element analysis of excised human femora based on precision -QCT.
B. Merz (1996)
The potential of multi-slice computed tomography based quantification of the structural anisotropy of vertebral trabecular bone.
Z. Tabor (2013)

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