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

被引:80
作者
Manske, S. L. [1 ,2 ]
Liu-Ambrose, T. [1 ,3 ]
Cooper, D. M. L. [4 ]
Kontulainen, S. [5 ]
Guy, P. [1 ]
Forster, B. B. [6 ]
McKay, H. A. [1 ,7 ]
机构
[1] Univ British Columbia, Dept Orthopaed, Ctr Hip Hlth & Musculoskeletal Res, Vancouver Coastal Hlth Res Inst, Vancouver, BC V5Z 3P1, Canada
[2] Univ Calgary, Fac Kinesiol, Calgary, AB, Canada
[3] Univ British Columbia, Dept Phys Therapy, Vancouver, BC V5Z 3P1, Canada
[4] Univ Saskatchewan, Dept Anat & Cell Biol, Saskatoon, SK, Canada
[5] Univ Saskatchewan, Coll Kinesiol, Saskatoon, SK, Canada
[6] Univ British Columbia, Dept Radiol, Vancouver, BC V5Z 3P1, Canada
[7] Univ British Columbia, Dept Family Practice, Vancouver, BC V5Z 3P1, Canada
基金
加拿大自然科学与工程研究理事会;
关键词
Bone strength; Cortical bone; Femoral neck; Proximal femur; QCT; Trabecular bone; QUANTITATIVE COMPUTED-TOMOGRAPHY; HIP FRACTURE RISK; STRENGTH; IMPACT; FALL; AGE; FORCE; POROSITY;
D O I
10.1007/s00198-008-0675-2
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
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. The relative contribution of femoral neck trabecular and cortical bone to proximal femur failure load is unclear. 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. 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 45A degrees regions. The femora were loaded to failure. 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. Both cortical and trabecular bone make significant contributions to failure load in ex vivo measures of bone strength.
引用
收藏
页码:445 / 453
页数:9
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