Image-based micro-finite-element modeling for improved distal radius strength diagnosis: moving from "bench" to "bedside"

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Pistoia, W.¹; van Rietbergen, B.²; Lochmüller, E.-M.³; Lill, C. A.⁴; Eckstein, F.⁵; Rüegsegger, P.¹

Image-based micro-finite-element modeling for improved distal radius strength diagnosis: moving from “bench” to “bedside”

J Clin Densitom. Summer 2004;7(2):153-160

©2004 Humana Press Inc.

Affiliations

¹Institute for Biomedical Engineering, University of Zürich and Swiss Federal Institute of Technology (ETH), Moussonstrasse 18, CH-8044 Zürich, Switzerland

²Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands

³Universitätsfrauenklinik, LMU München, Germany

⁴AO Research Institute, Davos, Switzerland, and Department of Orthopedic Surgery, University of Heidelberg, Germany

⁵Institute of Anatomy, LMU Münchena, Germany
Abstract and keywords

Although osteoporosis is characterized by quantitative (mass) and qualitative (structural) changes, standard clinical techniques (dual-energy X-ray absorptiometry, DXA) only measure the former. Three-dimensional micro-finite-element (micro-FE) models based on high-resolution images can account for structural aspects as well, and it has recently been shown that an improved prediction of distal radius strength is possible with micro-FE analysis. A clinical application of this technique, however, is limited by its high imaging and computational demands. The objective of this study is to investigate if an improved prediction of bone strength can be obtained as well when only a small part of the radius is used for micro-FE modeling. Images of a 1-cm region of the metaphysis of the distal radius of 54 cadaver arms (mean age: 82 ± 9 SD) made with a three-dimensional peripheral quantitative computed tomography (pQCT) device at 165-μm resolution formed the basis for micro-FE models that were used to predict the bone failure load. Following imaging, specimens were experimentally compressed to failure to produce a Colles'-type fracture. Failure loads predicted from micro-FE analyses agreed well with those measured experimentally (R² = 0.66, p < 0.001). Lower correlations were observed with bone mass (R² = 0.48, p < 0.001) and microstructural parameters (R² = 0.47, p < 0.001). Hence, even when only a small region is modeled, micro-FE analysis provides an improved prediction of radius strength.

Keywords: Colles’ fracture; dual X-ray absorptiometry (DXA); finite-element method; osteoporosis; peripheral quantitative computer tomography (pQCT)
Links

DOI: 10.1385/JCD:7:2:153

PubMed: 15181259

WoS: 000222153000005
History

Received: 2003-05-06

Accepted: 2003-09-16

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