Cortical and trabecular bone in the femoral neck both contribute to proximal femur failure load prediction

Manske, S. L.<sup>1,2</sup>; Liu-Ambrose, T.<sup>1,3</sup>; Cooper, D. M. L.<sup>4</sup>; Kontulainen, S.<sup>5</sup>; Guy, P.<sup>1</sup>; Forster, B. B.<sup>6</sup>; McKay, H. A.<sup>1,7</sup>

Affiliations

¹UBC Department of Orthopaedics, Centre for Hip Health and Musculoskeletal Research, Vancouver Coastal Health Research Institute, 302-2647 Willow Street, Vancouver, BC V5Z 3P1, Canada

²Faculty of Kinesiology, University of Calgary, Calgary, Canada

³Department of Physical Therapy, University of British Columbia, Vancouver, Canada

⁴Department of Anatomy and Cell Biology, University of Saskatchewan, Saskatoon, Canada

⁵College of Kinesiology, University of Saskatchewan, Saskatoon, Canada

⁶Department of Radiology, University of British Columbia, Vancouver, Canada

⁷Department of Family Practice, University of British Columbia, Vancouver, Canada

Abstract and keywords

Summary: We examined the contributions of femoral neck cortical and trabecular bone to proximal femur failure load. We found that trabecular bone mineral density explained a significant proportion of variance in failure load after accounting for total bone size and cortical bone mineral content or cortical area.

Introduction: The relative contribution of femoral neck trabecular and cortical bone to proximal femur failure load is unclear.

Objectives: Our primary objective was to determine whether trabecular bone mineral density (TbBMD) contributes to proximal femur failure load after accounting for total bone size and cortical bone content. Our secondary objective was to describe regional differences in the relationship among cortical bone, trabecular bone, and failure load within a cross-section of the femoral neck.

Materials and methods: We imaged 36 human cadaveric proximal femora using quantitative computed tomography (QCT). We report total bone area (ToA), cortical area (CoA), cortical bone mineral content (CoBMC), and TbBMD measured in the femoral neck cross-section and eight 45° regions. The femora were loaded to failure.

Results and observations: Trabecular bone mineral density explained a significant proportion of variance in failure load after accounting for ToA and then either CoBMC or CoA respectively. CoBMC contributed significantly to failure load in all regions of the femoral neck except the posterior region. TbBMD contributed significantly to failure load in all regions of the femoral neck except the inferoanterior, superoposterior, and the posterior regions.

Conclusion: Both cortical and trabecular bone make significant contributions to failure load in ex vivo measures of bone strength.

Keywords: Bone strength; Cortical bone; Femoral neck; Proximal femur; QCT; Trabecular bone

Links

DOI: 10.1007/s00198-008-0675-2

PubMed: 18661091

WoS: 000263260600012

History

Received: 2007-08-09

Accepted: 2008-05-29

Online: 2008-07-26

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2017	Draghici AE. Rescuing Osteoporotic Bone in Individuals With Spinal Cord Injury [PhD thesis]. Northeastern University; April 2017.
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