Effect of finite element model loading condition on fracture risk assessment in men and women: the AGES-Reykjavik study.
Effect of finite element model loading condition on fracture risk assessment in men and women: the AGES-Reykjavik study.
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DOI：
10.1016/j.bone.2013.07.028
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发表时间：
2013-11
期刊：
影响因子：
4.1
通讯作者：
Lang, T. F.
中科院分区：
文献类型：
--
作者：
Keyak, J. H.;Sigurdsson, S.;Karlsdottir, G. S.;Oskarsdottir, D.;Sigmarsdottir, A.;Kornak, J.;Harris, T. B.;Sigurdsson, G.;Jonsson, B. Y.;Siggeirsdottir, K.;Eiriksdottir, G.;Gudnason, V.;Lang, T. F.
关键词：
通过受试者特定的基于CT扫描的有限元（FE）模型计算的股骨近端（髋关节）强度已被探索作为识别受试者髋关节骨折风险的改进措施。然而，据我们所知，没有发表的研究报告的影响，负荷条件之间的关联事件髋关节骨折和髋关节强度。在本研究中，我们在雷克雅未克年龄基因/环境易感性（AGES）队列中进行了巢式年龄和性别匹配的病例对照研究。基线（骨折前）定量CT（QCT）扫描的5500名老年男性和女性受试者。在4 - 7年的随访中，51名男性和77名女性持续髋部骨折。从年龄和性别匹配的受试者中随机选择97名男性和152名女性作为对照。根据QCT数据，采用非线性材料特性的FE模型计算了每例受试者左髋关节在从大转子后外侧（FPL）、后部（FP）和外侧（FL）跌落时的FE强度。为了进行比较，还计算了站立载荷下的FE强度（FStance）和股骨总面积骨密度（aBMD）。在所有载荷条件下，男性骨折相关的强度降低是女性的两倍以上（p ≤ 0.01）。对于跌倒载荷，男性的后外侧载荷和女性的后外侧载荷与髋部骨折的发生密切相关。调整aBMD后，FP与女性骨折之间的相关性没有统计学意义（p = 0.08），表明FE强度在识别女性髋部骨折受试者方面与aBMD相比没有什么优势。然而，在男性中，在控制aBMD后，骨折受试者的FPL比对照组低424 N（11%）（p = 0.003）。因此，在男性中，后外侧载荷的FE模型包括关于aBMD以外的髋部骨折的信息。
Proximal femoral (hip) strength computed by subject-specific CT scan-based finite element (FE) models has been explored as an improved measure for identifying subjects at risk of hip fracture. However, to our knowledge, no published study has reported the effect of loading condition on the association between incident hip fracture and hip strength. In the present study, we performed a nested age- and sex-matched case-control study in the Age Gene/Environment Susceptibility (AGES) Reykjavik cohort. Baseline (pre-fracture) quantitative CT (QCT) scans of 5500 older male and female subjects were obtained. During 4-7 years follow-up, 51 men and 77 women sustained hip fractures. Ninety-seven men and 152 women were randomly selected as controls from a pool of age- and sex-matched subjects. From the QCT data, FE models employing nonlinear material properties computed FE-strength of the left hip of each subject in loading from a fall onto the posterolateral (FPL), posterior (FP) and lateral (FL) aspects of the greater trochanter. For comparison, FE strength in stance loading (FStance) and total femur areal bone mineral density (aBMD) were also computed. For all loading conditions, the reductions in strength associated with fracture in men were more than twice those in women (p≤0.01). For fall loading specifically, posterolateral loading in men and posterior loading in women were most strongly associated with incident hip fracture. After adjusting for aBMD, the association between FP and fracture in women fell short of statistical significance (p=0.08), indicating that FE strength provides little advantage over aBMD for identifying female hip fracture subjects. However, in men, after controlling for aBMD, FPL was 424 N (11%) less in subjects with fractures than in controls (p=0.003). Thus, in men, FE models of posterolateral loading include information about incident hip fracture beyond that in aBMD.
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DOI：
10.1097/01.blo.0000164400.37905.22
发表时间：
2005-08-01
影响因子：
4.2
作者：
Keyak, JH;Kaneko, TS;Skinner, HB
通讯作者：
Skinner, HB
影响因子：
4.1
作者：
Keyak, J. H.;Koyama, A. K.;Lang, T. F.
通讯作者：
Lang, T. F.
影响因子：
2.4
作者：
Keyak, JH;Rossi, SA;Skinner, HB
通讯作者：
Skinner, HB
影响因子：
2.4
作者：
Bessho, Masahiko;Ohnishi, Isao;Nakamura, Kozo
通讯作者：
Nakamura, Kozo
影响因子：
2.4
作者：
Cody, DD;Gross, GJ;Fyhrie, DP
通讯作者：
Fyhrie, DP