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

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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.

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Notes

  1. 34 of these specimens were included in a previous study [10].

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Acknowledgements

We thank D. Malpas for QCT data acquisition, C. Tang and P.M. de Bakker for assistance with mechanical testing, as well as D. Liu for the histological sectioning. We would also like to acknowledge D. Thomas for his invaluable assistance in the development of the region-based analysis macro. This study was supported by an Establishment Grant from the Michael Smith Foundation for Health Research (MSFHR). S.L. Manske was supported by the Natural Sciences and Engineering Research Council (Canada), Alberta Heritage Foundation for Medical Research and MSFHR. T. Liu-Ambrose is an MSFHR Scholar. H.A. McKay is an MSFHR Senior Scholar.

Conflicts of interest

None.

Author information

Authors and Affiliations

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

    S. L. Manske, T. Liu-Ambrose, P. Guy & H. A. McKay

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

    S. L. Manske

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

    T. Liu-Ambrose

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

    D. M. L. Cooper

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

    S. Kontulainen

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

    B. B. Forster

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

    H. A. McKay

Authors
  1. S. L. Manske
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  2. T. Liu-Ambrose
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  3. D. M. L. Cooper
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  4. S. Kontulainen
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  5. P. Guy
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  6. B. B. Forster
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  7. H. A. McKay
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Corresponding author

Correspondence to H. A. McKay.

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Manske, S.L., Liu-Ambrose, T., Cooper, D.M.L. et al. Cortical and trabecular bone in the femoral neck both contribute to proximal femur failure load prediction. Osteoporos Int 20, 445–453 (2009). https://doi.org/10.1007/s00198-008-0675-2

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  • DOI: https://doi.org/10.1007/s00198-008-0675-2

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