Bone mineral content and mechanical strength of the femoral neck

Dalén, Nils; Hellström, Lars-Gösta; Jacobson, Bertil

Affiliations

¹Department of Medical Engineering, Karolinska Institute

²Department of Orthopedic Surgery, Karolinska Sjukhuset, Stockholm, Sweden

Abstract and keywords

The bone mineral content of the femoral neck of 61 autopsy specimens was assayed by x-ray spectrophotometry. The mechanical strength of the specimens was also determined experimentally by applying a compressive force perpendicularly to the shaft. The ultimate force at fracture was obtained from force/displacement plots. a coefficient of correlation of 0.89 between bone mineral content of the femoral neck and the ultimate force at fracture was found. Even when limited to a group of women aged 67–80 a fairly close correlation was found. This indicates that the bone mineral level, measured in vivo, can be used as a criterion of the risk of fracture in elderly women.

Keywords: femoral neck, mechanical strength, bone mineral content, x-ray spectrophotometry

Links

DOI: 10.3109/17453677608988728

PubMed: 998185

WoS: A1976CN11000006

History

Accepted: 1976-05-18

Cited Works (3)

Year	Entry
1973	Simkin A, Robin G. The mechanical testing of bone in bending. J Biomech. 1973;6(1):31-39.
1974	Schoenfeld CM, Lautenschlager EP, Meyer PR. Mechanical properties of human cancellous bone in the femoral head. Med Biol Eng. 1974;12(3):313-317.
1970	Currey JD. The mechanical properties of bone. Clin Orthop Relat Res. November–December 1970;73:210-231.

Cited By (52)

Year	Entry
1985	Cummings SR, Kelsey JL, Nevitt MC, O'Dowd KJ. Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev. 1985;7:178-208.
2002	Müller R. The Zürich experience: one decade of three-dimensional high-resolution computed tomography. Top Magn Reson Imaging. 2002;13(5):307-322.
2001	Turner CH, Burr DB. Experimental techniques for bone mechanics. In: Cowin SC, ed. Bone Mechanics Handbook. 2nd ed. Boca Raton, FL: CRC Press; 2001:7-1–7-35.
2001	Villarraga ML, Ford CM. Applications of bone mechanics. In: Cowin SC, ed. Bone Mechanics Handbook. 2nd ed. Boca Raton, FL: CRC Press; 2001:33-1–33-33.
1988	Melton LJ III, Chao EYS, Lane J. Biomechanical aspects of fractures. In: Riggs BL, Melton LJ III, eds. Osteoporosis: Etiology, Diagnosis, and Management. New York, NY: Raven Press; 1988:111-131.
1988	Mazess RB, Wahner HW. Nuclear medicine and densitometry. In: Riggs BL, Melton LJ III, eds. Osteoporosis: Etiology, Diagnosis, and Management. New York, NY: Raven Press; 1988:251-295.
1992	Myers ER, Greenspan SL, Hayes WC. Biomechanics of hip fracture risk. In: Proceedings of the 2nd Injury Prevention Through Biomechanics Symposium. April 10-11, 1992; Detroit, MI.41-46.
1986	Melton LJ III, Wahner HW, Richelson LS, O'Fallon WM, Riggs BL. Osteoporosis and the risk of hip fracture. Am J Epidemiol. August 1986;124(2):254-261.
1985	Cummings SR. Are patients with hip fractures more osteoporotic? review of the evidence. Am J Med. March 1985;78(3):487-494.
1997	Cheng XG, Lowet G, Boonen S, Nicholson PHF, Brys P, Nijs J, Dequeker J. Assessment of the strength of proximal femur in vitro: relationship to femoral bone mineral density and femoral geometry. Bone. March 1997;20(3):213-218.
1997	Lang TF, Keyak JH, Heitz MW, Augat P, Liu Y, Mathur A, Genant HK. Volumetric quantitative computed tomography of the proximal femur: precision and relation to bone strength. Bone. July 1997;21(1):101-108.
1997	Laib A, Hildebrand T, Häuselmann HJ, Rüegsegger P. Ridge number density: a new parameter for in vivo bone structure analysis. Bone. December 1997;21(6):541-546.
1999	Laib A, Rüegsegger P. Calibration of trabecular bone structure measurements of in vivo three-dimensional peripheral quantitative computed tomography with 28-μm-resolution microcomputed tomography. Bone. January 1999;24(1):35-39.
1990	Mazess RB. Fracture risk: a role for compact bone. Calcif Tiss Int. October 1990;47(4):191-193.
1993	Myers ER, Hecker AT, Rooks DS, Hipp JA, Hayes WC. Geometric variables from DXA of the radius predict forearm fracture load in vitro. Calcif Tiss Int. March 1993;52(3):199-204.
1993	Squillante RG, Williams JL. Videodensitometry of osteons in females with femoral neck fractures. Calcif Tiss Int. April 1993;52(4):273-277.
1995	Bouxsein ML, Courtney AC, Hayes WC. Ultrasound and densitometry of the calcaneus correlate with the failure loads of cadaveric femurs. Calcif Tiss Int. February 1995;56(2):99-103.
1996	Pinilla TP, Boardman KC, Bouxsein ML, Myers ER, Hayes WC. Impact direction from a fall influences the failure load of the proximal femur as much as age-related bone loss. Calcif Tiss Int. April 1996;58(4):231-235.
1985	Melton LJ, Riggs BL. Risk factors for injury after a fall. Clin Geriatr Med. August 1985;1(3):525-539.
1982	Leichter I, Margulies JY, Weinreb A, Mizrahi J, Robin GC, Conforty B, Makin M, Bloch B. The relationship between bone density, mineral content, and mechanical strength in the femoral neck. Clin Orthop Relat Res. March 1982;163:272-281.
1982	Mazess RB. On aging bone loss. Clin Orthop Relat Res. May 1982;165:239-252.
1983	Bohr H, Schaadt O. Bone mineral content of femoral bone and the lumbar spine measured in women with fracture of the femoral neck by dual photon absorptiometry. Clin Orthop Relat Res. October 1983;179:240-245.
1988	Alho A, Husby R, Høiseth A. Bone mineral content and mechanical strength: an ex vivo study on human femora at autopsy. Clin Orthop Relat Res. February 1988;227:292-297.
1997	Hildebrand T, Rüegsegger P. Quantification of bone microarchitecture with the structure model index. Comput Methods Prog Biomed. 1997;1(1):15-23.
1990	Beck TJ, Ruff CB, Warden KE, Scott wW Jr, Rao GU. Predicting femoral neck strength from bone mineral data: a structural approach. Invest Radiol. January 1990;25(1):6-18.
1981	Kriewall TJ, McPherson GK, Tsai AC. Bending properties and ash content of fetal cranial bone. J Biomech. 1981;14(2):73-79.
1984	Martin RB, Burr DB. Non-invasive measurement of long bone cross-sectional moment of inertia by photon absorptiometry. J Biomech. 1984;17(3):195-201.
2007	Cristofolini L, Juszczyk M, Martelli S, Taddei F, Viceconti M. In vitro replication of spontaneous fractures of the proximal human femur. J Biomech. 2007;40(13):2837-2845.
2011	Juszczyk MM, Cristofolini L, Viceconti M. The human proximal femur behaves linearly elastic up to failure under physiological loading conditions. J Biomech. August 11, 2011;44(12):2259-2266.
1991	Lotz JC, Cheal EJ, Hayes WC. Fracture prediction for the proximal femur using finite element models, I: linear analysis. J Biomech Eng. 1991;113(4):353-360.
1990	Lotz JC, Hayes WC. The use of quantitative computed tomography to estimate risk of fracture of the hip from falls. J Bone Joint Surg. June 1990;72A(5):689-700.
1995	Courtney AC, Wachtel EF, Myers ER, Hayes WC. Age-related reductions in the strength of the femur tested in a fall-loading configuration. J Bone Joint Surg. March 1995;77A(3):387-395.
1982	Wicks M, Garrett R, Vernon-Roberts B, Fazzalari N. Absence of metabolic bone disease in the proximal femur in patients with fracture of the femoral neck. J Bone Joint Surg. 1982;64B(3):319-322.
1988	Mazess RB, Barden H, Ettinger M, Schultz E. Bone density of the radius, spine, and proximal femur in osteoporosis. J Bone Miner Res. February 1988;3(1):13-18.
1989	Esses SI, Lotz JC, Hayes WC. Biomechanical properties of the proximal femur determined in vitro by single‐energy quantitative computed tomography. J Bone Miner Res. October 1989;4(5):715-722.
2004	Eckstein F, Wunderer C, Boehm H, Kuhn V, Priemel M, Link TM, Lochmüller E-M. Reproducibility and side differences of mechanical tests for determining the structural strength of the proximal femur. J Bone Miner Res. March 2004;19(3):379-385.
1988	Melton LJ III, Kan SH, Wahner HW, Riggs BL. Lifetime fracture risk: an approach to hip fracture risk assessment based on bone mineral density and age. J Clin Epidemiol. 1988;41(10):985-994.
2003	Ammann P, Rizzoli R. Bone strength and its determinants. Osteoporos Int. March 2003;14(suppl 3):S13-S18.
2020	Bouxsein ML, Zysset P, Glüer CC, McClung M, Biver E, Pierroz DD, Ferrari SL; IOF Working Group on Hip Bone Strength as a Therapeutic Target. Perspectives on the non-invasive evaluation of femoral strength in the assessment of hip fracture risk. Osteoporos Int. March 2020;31(3):393-408.
1991	Hayes WC, Piazza SJ, Zysset PK. Biomechanics of fracture risk prediction of the hip and spine by quantitative computed tomography. Radiol Clin North Am. 1991;29(1):1-18.
1998	Müller R, Gerber SC, Hayes WC. Micro-compression: a novel technique for the nondestructive assessment of local bone failure. Technol Health Care. December 1998;6(5-6):433-444.
1999	Laib A. Microarchitecture of the Human Radius Assessed With High Resolution in Vivo 3D-QCT [PhD thesis]. Swiss Federal Institute of Technology Zürich; 1999.
2005	Stauber M. Volumetric Spatial Decomposition of Porous Microstructures: A Framework for Element Based Analysis of Trabecular Bone [PhD thesis]. Swiss Federal Institute of Technology Zürich; 2005.
2010	Müller T. Bioimaging and Biomechanics of Bone Competence and Implant Stability [PhD thesis]. Swiss Federal Institute of Technology Zürich; 2010.
1994	Courtney AC. Mechanical Properties of the Proximal Femur: Changes With Age [PhD thesis]. Cambridge, MA: Harvard University; May 1994.
1997	Heinonen A. Exercise as an Osteogenic Stimulus [PhD thesis]. University of Jyväskylä; 1997.
1988	Lotz JC. Hip Fracture Risk Predictions by X-Ray Computed Tomography [PhD thesis]. Cambridge, MA: Massachusetts Institute of Technology; August 1988.
1999	Schaffner G. Assessment of Hip Fracture Risk in Astronauts Exposed to Long-Term Weightlessness [PhD thesis]. Cambridge, MA: Massachusetts Institute of Technology; August 1999.
2011	Kristensen E. The Role of Growth Hormone in the Development of Bone Microarchitecture, Craniofacial Shape and Bone Strength [PhD thesis]. Calgary, AB: University of Calgary; February 2011.
1996	Keyak JH. Prediction of Femoral Strength Using Automated Finite Element Modeling [PhD thesis]. Berkeley, CA: Berkeley, University of California; 1996.
2019	Küsters NV. Auswirkungen des Alters und der Knochenmikroarchitektur auf die trabekuläre Knochenmineralisationsdichteverteilung: Eine rasterelektronenmikroskopische Studie an 152 humanen Beckenkammbiopsien [PhD thesis]. Hamburg, Germany: Universität Hamburg; 2019.
1998	Yeni YN. Fracture Mechanics of Human Cortical Bone: The Relationship of Geometry, Microstructure and Composition With the Fracture of the Tibia, Femoral Shaft and the Femoral Neck [PhD thesis]. West Virginia University; 1998.