nach oben

Osteoporosis International

Erschienen in:

01.07.2011 | Original Article

Differences in femoral neck geometry associated with age and ethnicity

verfasst von: K. M. Kim, J. K. Brown, K. J. Kim, H. S. Choi, H. N. Kim, Y. Rhee, S.-K. Lim

Erschienen in: Osteoporosis International | Ausgabe 7/2011

Einloggen, um Zugang zu erhalten

Abstract

Summary

We studied femoral geometry in relation to age and ethnicity in a cross-sectional study. Age-associated cortical thinning showed the most pronounced effect, and Koreans studied here had thicker cortices and lower buckling ratios than those reported for other races. Cortical thickness may thus be a major determinant of hip fracture risk.

Introduction

The rate of hip fracture varies by age and ethnicity. The geometric properties of the femur influence femoral strength and fragility, but differences in femoral geometry according to age and ethnicity are poorly understood. To explain the high prevalence of hip fractures in the elderly and the relatively low hip fracture rate in Asian populations, we studied age-related changes and ethnic differences in femoral geometry.

Methods

We recruited 214 peri- or postmenopausal women aged 46 to 85 years (mean age, 60.6 years). Their proximal femoral bone mineral densities (BMD) were measured by quantitative computed tomography and further analyzed geometric properties.

Results

We observed large declines in trabecular volumetric bone mineral density associated with aging (33.03% less than the reference value in the oldest group, respectively). Cortical thickness decreased remarkably with age as well, and only 53.94% of the baseline value remained in the oldest group. As a result, the cortical buckling ratio increased geometrically and reached 239.14% of the reference value in the oldest group. In comparisons with other ethnic groups, Korean subjects had thicker cortices than their American, European, and African counterparts.

Conclusions

In this cross-sectional study, cortical thickness showed a pronounced age-associated decrease, and the cortical buckling ratio showed a strong age-associated increase. This may in part explain the higher rates of hip fractures in the elderly. When compared with other races, Asians had thicker cortical bone and lower buckling ratios, which may partially explain the lower prevalence of hip fractures in Asians.

Nur mit Berechtigung zugänglich

Golden SH, Robinson KA, Saldanha I, Anton B, Ladenson PW (2009) Clinical review: prevalence and incidence of endocrine and metabolic disorders in the United States: a comprehensive review. J Clin Endocrinol Metab 94:1853–1878PubMedCrossRef

Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353:878–882PubMedCrossRef

Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301:513–521PubMedCrossRef

European Foundation for Osteoporosis Bone Disease, National Osteoporosis Foundation, National Institute of Arthritis and Musculoskeletal and Skin Diseases (1993) Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med 94:646–650CrossRef

Kanis JA (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int 4:368–381PubMedCrossRef

El-Kaissi S, Pasco JA, Henry MJ et al (2005) Femoral neck geometry and hip fracture risk: the Geelong osteoporosis study. Osteoporos Int 16:1299–1303PubMedCrossRef

Szulc P, Duboeuf F, Schott AM, Dargent-Molina P, Meunier PJ, Delmas PD (2006) Structural determinants of hip fracture in elderly women: re-analysis of the data from the EPIDOS study. Osteoporos Int 17:231–236PubMedCrossRef

Kaptoge S, Beck TJ, Reeve J et al (2008) Prediction of incident hip fracture risk by femur geometry variables measured by hip structural analysis in the study of osteoporotic fractures. J Bone Miner Res 23:1892–1904PubMedCrossRef

Cheng XG, Lowet G, Boonen S et al (1997) Assessment of the strength of proximal femur in vitro: relationship to femoral bone mineral density and femoral geometry. Bone 20:213–218PubMedCrossRef

10.

Alonso CG, Curiel MD, Carranza FH, Cano RP, Perez AD (2000) Femoral bone mineral density, neck-shaft angle and mean femoral neck width as predictors of hip fracture in men and women. Multicenter project for research in osteoporosis. Osteoporos Int 11:714–720PubMedCrossRef

11.

Center JR, Nguyen TV, Pocock NA, Eisman JA (2004) Volumetric bone density at the femoral neck as a common measure of hip fracture risk for men and women. J Clin Endocrinol Metab 89:2776–2782PubMedCrossRef

12.

Siris ES, Chen YT, Abbott TA et al (2004) Bone mineral density thresholds for pharmacological intervention to prevent fractures. Arch Intern Med 164:1108–1112PubMedCrossRef

13.

Wainwright SA, Marshall LM, Ensrud KE et al (2005) Hip fracture in women without osteoporosis. J Clin Endocrinol Metab 90:2787–2793PubMedCrossRef

14.

Lacroix AZ, Beck TJ, Cauley JA et al (2010) Hip structural geometry and incidence of hip fracture in postmenopausal women: what does it add to conventional bone mineral density? Osteoporos Int 21:919–929PubMedCrossRef

15.

Hui SL, Slemenda CW, Johnston CC Jr (1988) Age and bone mass as predictors of fracture in a prospective study. J Clin Invest 81:1804–1809PubMedCrossRef

16.

Cooper C, Melton LJ 3rd (1992) Epidemiology of osteoporosis. Trends Endocrinol Metab 3:224–229PubMedCrossRef

17.

Lau EM, Lee JK, Suriwongpaisal P et al (2001) The incidence of hip fracture in four Asian countries: the Asian osteoporosis study (AOS). Osteoporos Int 12:239–243PubMedCrossRef

18.

Xu L, Lu A, Zhao X, Chen X, Cummings SR (1996) Very low rates of hip fracture in Beijing, People’s Republic of China: the Beijing osteoporosis project. Am J Epidemiol 144:901–907PubMed

19.

Chang KP, Center JR, Nguyen TV, Eisman JA (2004) Incidence of hip and other osteoporotic fractures in elderly men and women: Dubbo osteoporosis epidemiology study. J Bone Miner Res 19:532–536PubMedCrossRef

20.

Anderson JY, Trinkaus E (1998) Patterns of sexual, bilateral and interpopulational variation in human femoral neck-shaft angles. J Anat 192:279–285PubMedCrossRef

21.

Guermazi A, Mohr A, Grigorian M, Taouli B, Genant HK (2002) Identification of vertebral fractures in osteoporosis. Semin Musculoskelet Radiol 6:241–252PubMedCrossRef

22.

Rivadeneira F, Zillikens MC, De Laet CE et al (2007) Femoral neck BMD is a strong predictor of hip fracture susceptibility in elderly men and women because it detects cortical bone instability: the Rotterdam study. J Bone Miner Res 22:1781–1790PubMedCrossRef

23.

Nelson DA, Pettifor JM, Barondess DA, Cody DD, Uusi-Rasi K, Beck TJ (2004) Comparison of cross-sectional geometry of the proximal femur in white and black women from Detroit and Johannesburg. J Bone Miner Res 19:560–565PubMedCrossRef

24.

Bell KL, Loveridge N, Power J et al (1999) Structure of the femoral neck in hip fracture: cortical bone loss in the inferoanterior to superoposterior axis. J Bone Miner Res 14:111–119PubMedCrossRef

25.

Crabtree N, Loveridge N, Parker M et al (2001) Intracapsular hip fracture and the region-specific loss of cortical bone: analysis by peripheral quantitative computed tomography. J Bone Miner Res 16:1318–1328PubMedCrossRef

26.

Mayhew PM, Thomas CD, Clement JG et al (2005) Relation between age, femoral neck cortical stability, and hip fracture risk. Lancet 366:129–135PubMedCrossRef

27.

Poole KE, Mayhew PM, Rose CM et al (2009) Changing structure of the femoral neck across the adult female lifespan. J Bone Miner Res 25:482–491CrossRef

28.

Beck TJ, Looker AC, Ruff CB, Sievanen H, Wahner HW (2000) Structural trends in the aging femoral neck and proximal shaft: analysis of the third national health and nutrition examination survey dual-energy X-ray absorptiometry data. J Bone Miner Res 15:2297–2304PubMedCrossRef

29.

Partanen J, Jms T, Jalovaara P (2001) Influence of the upper femur and pelvic geometry on the risk and type of hip fractures. J Bone Miner Res 16:1540–1546PubMedCrossRef

30.

Silva MJ (2007) Biomechanics of osteoporotic fractures. Injury 38:69–76CrossRef

31.

Bouxsein ML (2005) Determinants of skeletal fragility. Best Pract Res Clin Rheumatol 19:897–911PubMedCrossRef

32.

De Laet CE, van Hout BA, Burger H, Hofman A, Pols HA (1997) Bone density and risk of hip fracture in men and women: cross sectional analysis. BMJ 315:221–225PubMed

33.

Seeman E (2002) Pathogenesis of bone fragility in women and men. Lancet 359:1841–1850PubMedCrossRef

34.

Cummings SR, Cauley JA, Palermo L et al (1994) Racial differences in hip axis lengths might explain racial differences in rates of hip fracture. Study of osteoporotic fractures research group. Osteoporos Int 4:226–229PubMedCrossRef

35.

Gregory JS, Aspden RM (2008) Femoral geometry as a risk factor for osteoporotic hip fracture in men and women. Med Eng Phys 30:1275–1286PubMedCrossRef

36.

Seeman E (2008) Structural basis of growth-related gain and age-related loss of bone strength. Rheumatol Oxf 47(Suppl 4):iv2–iv8CrossRef

37.

Bonnick SL, Beck TJ, Cosman F, Hochberg MC, Wang H, de Papp AE (2009) DXA-based hip structural analysis of once-weekly bisphosphonate-treated postmenopausal women with low bone mass. Osteoporos Int 20:911–921PubMedCrossRef

38.

Uusi-Rasi K, Beck TJ, Semanick LM et al (2006) Structural effects of raloxifene on the proximal femur: results from the multiple outcomes of raloxifene evaluation trial. Osteoporos Int 17:575–586PubMedCrossRef

39.

Pulkkinen P, Partanen J, Jalovaara P, Jamsa T (2004) Combination of bone mineral density and upper femur geometry improves the prediction of hip fracture. Osteoporos Int 15:274–280PubMedCrossRef

40.

Kotowicz MA, Melton LJ, Cooper C, Atkinson EJ, O’Fallon WM, Riggs BL (1994) Risk of hip fracture in women with vertebral fracture. J Bone Miner Res 9:599–605PubMedCrossRef

41.

Melton LJ, Atkinson EJ, Cooper C, O’Fallon WM, Riggs BL (1999) Vertebral fractures predict subsequent fractures. Osteoporos Int 10:214–221PubMedCrossRef

42.

Cano A, Dapa S, Noguera I et al (2008) Comparative effects of 17beta-estradiol, raloxifene and genistein on bone 3D microarchitecture and volumetric bone mineral density in the ovariectomized mice. Osteoporos Int 19:793–800PubMedCrossRef

43.

Yeh JK, Chen MM, Aloia JF (1997) Effects of 17 beta-estradiol administration on cortical and cancellous bone of ovariectomized rats with and without hypophysectomy. Bone 20:413–420PubMedCrossRef

44.

Mohamed AM (2003) Bone loss and bone size after menopause. N Engl J Med 349:1671, author reply 1671PubMedCrossRef

45.

Prevrhal S, Shepherd JA, Faulkner KG, Gaither KW, Black DM, Lang TF (2008) Comparison of DXA hip structural analysis with volumetric QCT. J Clin Densitom 11:232–236PubMedCrossRef

46.

Khoo BCC, Brown K, Cann C et al (2009) Comparison of QCT-derived and DXA-derived areal bone mineral density and T scores. Osteoporos Int 20:1539–1545PubMedCrossRef

47.

Engelke K, Libanati C, Liu Y et al (2009) Quantitative computed tomography (QCT) of the forearm using general purpose spiral whole-body CT scanners: accuracy, precision and comparison with dual-energy X-ray absorptiometry (DXA). Bone 45:110–118PubMedCrossRef

Titel: Differences in femoral neck geometry associated with age and ethnicity
verfasst von: K. M. Kim
J. K. Brown
K. J. Kim
H. S. Choi
H. N. Kim
Y. Rhee
S.-K. Lim
Publikationsdatum: 01.07.2011
Verlag: Springer-Verlag
Erschienen in: Osteoporosis International / Ausgabe 7/2011
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-010-1459-z

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Summary

Introduction

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 7/2011

Atypical femoral stress fractures in bisphosphonate-free patients

Vertebral fracture risk (VFR) score for fracture prediction in postmenopausal women

Dopaminergic drugs and the risk of hip or femur fracture: a population-based case–control study

Coordinator-based systems for secondary prevention in fragility fracture patients

Multifactorial evaluation and treatment of persons with a high risk of recurrent falling was not cost-effective