Osteoporosis International

, Volume 20, Issue 3, pp 445–453

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

Authors

  • S. L. Manske
    • UBC Department of Orthopaedics, Centre for Hip Health and Musculoskeletal ResearchVancouver Coastal Health Research Institute
    • Faculty of KinesiologyUniversity of Calgary
  • T. Liu-Ambrose
    • UBC Department of Orthopaedics, Centre for Hip Health and Musculoskeletal ResearchVancouver Coastal Health Research Institute
    • Department of Physical TherapyUniversity of British Columbia
  • D. M. L. Cooper
    • Department of Anatomy and Cell BiologyUniversity of Saskatchewan
  • S. Kontulainen
    • College of KinesiologyUniversity of Saskatchewan
  • P. Guy
    • UBC Department of Orthopaedics, Centre for Hip Health and Musculoskeletal ResearchVancouver Coastal Health Research Institute
  • B. B. Forster
    • Department of RadiologyUniversity of British Columbia
    • UBC Department of Orthopaedics, Centre for Hip Health and Musculoskeletal ResearchVancouver Coastal Health Research Institute
    • Department of Family PracticeUniversity of British Columbia
Original Article

DOI: 10.1007/s00198-008-0675-2

Cite this article as:
Manske, S.L., Liu-Ambrose, T., Cooper, D.M.L. et al. Osteoporos Int (2009) 20: 445. doi:10.1007/s00198-008-0675-2

Abstract

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 strengthCortical boneFemoral neckProximal femurQCTTrabecular bone

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2008