Femur strength predictions by nonlinear homogenized voxel finite element models reflect the microarchitecture of the femoral neck

Gianluca Iori, Laura Peralta, Andreas Reisinger, Frans Heyer, Caroline Wyers, Joop van den Bergh, Dieter Pahr, Kay Raum*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

In the human femoral neck, the contribution of the cortical and trabecular architecture to mechanical strength is known to depend on the load direction.

In this work, we investigate if QCT-derived homogenized voxel finite element (hvFE) simulations of varying hip loading conditions can be used to study the architecture of the femoral neck. The strength of 19 pairs of human femora was measured ex vivo using nonlinear hvFE models derived from high-resolution peripheral QCT scans (voxel size: 30.3 mu m). Standing and side-backwards falling loads were modeled. Quasi-static mechanical tests were performed on 20 bones for comparison. Associations of femur strength with volumetric bone mineral density (vBMD) or microstructural parameters of the femoral neck obtained from high-resolution QCT were compared between mechanical tests and simulations and between standing and falling loads.

Proximal femur strength predictions by hvFE models were positively associated with the vBMD of the femoral neck (R-2 > 0.61, p <0.001), as well as with its cortical thickness (R-2 > 0.27, p <0.001), trabecular bone volume fraction (R-2 = 0.42, p <0.001) and with the first two principal components of the femoral neck architecture (R-2 > 0.38, p <0.001). Associations between femur strength and femoral neck microarchitecture were stronger for one-legged standing than for side-backwards falling. For both loading directions, associations between structural parameters and femur strength from hvFE models were in good agreement with those from mechanical tests. This suggests that hvFE models can reflect the load-direction-specific contribution of the femoral neck microarchitecture to femur strength. (C) 2020 IPEM. Published by Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)60-66
Number of pages7
JournalMedical Engineering & Physics
Volume79
DOIs
Publication statusPublished - May 2020

Keywords

  • Osteoporosis
  • Femoral neck
  • Bone strength
  • Finite element analysis
  • Hip fragility
  • PROXIMAL FEMUR
  • FRACTURE LOAD
  • CORTICAL BONE
  • HIP FRACTURE
  • TRABECULAR BONE
  • VALIDATION
  • FAILURE
  • CORTEX

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