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Relationships Between Femoral Strength Evaluated by Nonlinear Finite Element Analysis and BMD, Material Distribution and Geometric Morphology

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Abstract

Precise quantification of femur strength and accurate assessment of hip fracture risk would help physicians to identify individuals with high risk and encourage them to take preventive interventions. A major contributing factor of hip fracture is the reduction of hip strength, determined by the bone quality. Bone mineral density (BMD) alone cannot determine bone strength accurately. In this paper, subject-specific quantitative computer tomography (QCT) image-based finite element analyses were conducted to identify the quantitative relationships between femoral strength and BMD, material distribution and geometric morphology. Sixty-six subjects with QCT data of hip region were selected from the MrOS cohorts in Hong Kong. Subject-specific nonlinear finite element models were developed to predict strengths of proximal femurs. The models took non-linear elasto-plasticity and heterogeneity of bone tissues into consideration and derived bone strengths with proper bone failure criteria. From finite element analysis (FEA), relationships between femoral strength and BMD, material distribution, and geometric parameters were determined. Results showed that FEA-predicted femoral strength was highly correlated with BMD, material distribution, height, weight, diameters of femoral head (HD), and femoral neck (ND), as well as the moment arm for femoral neck bending—offset (OFF). Through principal components analysis, three independent principal components (PCs) were extracted. PC1 was the component of bone material quality. PC2 included height, weight, HD, and ND. PC3 mainly represented OFF. Multivariate linear regression showed that the PCs were strongly predictive of the FEA-predicted strength. This study provided quantitative information regarding the contributing factors of proximal femur strength and showed that such a biomechanical approach may have clinical potential in noninvasive assessment of hip fracture risk.

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Acknowledgments

MrOS is a project supported by the NIH USA (No. AR049439). This work is supported by The Hong Kong Polytechnic University Research Grants (No. G-U701), grants from National Natural Science Foundation of China (Nos. 10972090, 10832012 and 11120101001), and the Fundamental Research Funds for the Central Universities.

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None.

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Authors and Affiliations

  1. Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China

    He Gong & Ming Zhang

  2. Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China

    He Gong & Yubo Fan

  3. Institute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, China

    Wai Leung Kwok & Ping Chung Leung

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  1. He Gong
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  2. Ming Zhang
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  3. Yubo Fan
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  4. Wai Leung Kwok
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  5. Ping Chung Leung
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Correspondence to Ming Zhang.

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Associate Editor Sean S. Kohles oversaw the review of this article.

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Gong, H., Zhang, M., Fan, Y. et al. Relationships Between Femoral Strength Evaluated by Nonlinear Finite Element Analysis and BMD, Material Distribution and Geometric Morphology. Ann Biomed Eng 40, 1575–1585 (2012). https://doi.org/10.1007/s10439-012-0514-7

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  • DOI: https://doi.org/10.1007/s10439-012-0514-7

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