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Robust QCT/FEA Models of Proximal Femur Stiffness and Fracture Load During a Sideways Fall on the Hip

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Abstract

Clinical implementation of quantitative computed tomography-based finite element analysis (QCT/FEA) of proximal femur stiffness and strength to assess the likelihood of proximal femur (hip) fractures requires a unified modeling procedure, consistency in predicting bone mechanical properties, and validation with realistic test data that represent typical hip fractures, specifically, a sideways fall on the hip. We, therefore, used two sets (n = 9, each) of cadaveric femora with bone densities varying from normal to osteoporotic to build, refine, and validate a new class of QCT/FEA models for hip fracture under loading conditions that simulate a sideways fall on the hip. Convergence requirements of finite element models of the first set of femora led to the creation of a new meshing strategy and a robust process to model proximal femur geometry and material properties from QCT images. We used a second set of femora to cross-validate the model parameters derived from the first set. Refined models were validated experimentally by fracturing femora using specially designed fixtures, load cells, and high speed video capture. CT image reconstructions of fractured femora were created to classify the fractures. The predicted stiffness (cross-validation R 2 = 0.87), fracture load (cross-validation R 2 = 0.85), and fracture patterns (83% agreement) correlated well with experimental data.

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Acknowledgments

The authors thank Dr. Mark Bolander, Jim Bronk, Vincent Lambert, Dr. Xiaoliang Qin, Alexander Cong, Mike Burke, Brant Newman, Larry Berglund, Dr. Jodie Christner, Dr. Cynthia McCollough, and Elizabeth Atkinson for their valuable contributions to this study. This study was financially supported by the Grainger Foundation: Grainger Innovation Fund and NIH grant AR027065Z-30S1. The authors thank the Musculoskeletal Transplant Foundation for providing the specimens, and the Opus CT Imaging Resource of Mayo Clinic (NIH construction grant RR018898) for CT imaging of the femora.

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Authors and Affiliations

  1. Division of Engineering, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Dan Dragomir-Daescu, Sean McEligot, Yifei Dai, Rachel C. Entwistle, Christina Salas & Kevin E. Bennet

  2. College of Medicine, Mayo Clinic, Rochester, MN, USA

    Dan Dragomir-Daescu, L. Joseph Melton III, Sundeep Khosla & Shreyasee Amin

  3. Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA

    L. Joseph Melton III & Shreyasee Amin

  4. Divisions of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA

    Sundeep Khosla

  5. Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA

    Shreyasee Amin

  6. Department of Electrical Engineering, Mathematics, and Computer Science, Twente University, Building Carré, Room 4.430, P.O. Box 217, 7500 AE, Enschede, The Netherlands

    Jorn Op Den Buijs

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  1. Dan Dragomir-Daescu
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  3. Sean McEligot
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  6. Christina Salas
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  8. Kevin E. Bennet
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  9. Sundeep Khosla
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Correspondence to Dan Dragomir-Daescu or Jorn Op Den Buijs.

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Associate Editor Sean S. Kohles oversaw the review of this article.

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Dragomir-Daescu, D., Op Den Buijs, J., McEligot, S. et al. Robust QCT/FEA Models of Proximal Femur Stiffness and Fracture Load During a Sideways Fall on the Hip. Ann Biomed Eng 39, 742–755 (2011). https://doi.org/10.1007/s10439-010-0196-y

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  • DOI: https://doi.org/10.1007/s10439-010-0196-y

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