ArticleBiomechanics and modeling in mechanobiology2017
Prediction of femoral strength using 3D finite element models reconstructed from DXA images: validation against experiments.
Article in Biomechanics and modeling in mechanobiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 48 citations in OpenAlex.
- Prediction accuracy of femoral and tibial stress and strain using statistical shape and density model-based finite element models in paediatrics.Biomechanics and modeling in mechanobiology · 2025Article
- Relationship between areal BMD, FRAX®, and femoral strength in community-dwelling older Asian adults.Archives of osteoporosis · 2025Article
- Variations over time in proximal femoral strength in young adult men are not explained by areal bone mineral density alone.JBMR plus · 2025Article
- Critical evaluation of 3D-DXA and 3D-Shaper: methodological limitations and their implications.JBMR plus · 2025Review
- Inelastic mechanical descriptors for osteoporotic hip fracture discrimination with 3D-DXA-based nonlinear finite element models.Frontiers in bioengineering and biotechnology · 2025Article
- Value of CT-Based 3D Reconstruction in Analyzing Fracture Line Distribution in Postmenopausal Women with Osteoporotic Pelvic Fractures.International journal of general medicine · 2025Article
- Geometry and bone mineral density determinants of femoral neck strength changes following exercise.Biomechanics and modeling in mechanobiology · 2023Article
- 2D-3D reconstruction of the proximal femur from DXA scans: Evaluation of the 3D-Shaper software.Frontiers in bioengineering and biotechnology · 2023Article
- Establishment of a Finite Element Model of Normal Nasal Bone and Analysis of Its Biomechanical Characteristics.Emergency medicine international · 2023Article
- Bone Fractures Numerical Analysis in a Femur Affected by Osteogenesis Imperfecta.Children (Basel, Switzerland) · 2021Article
- Finite Element Assessment of Bone Fragility from Clinical Images.Current osteoporosis reports · 2021Review
- Statistical Shape and Appearance Models: Development Towards Improved Osteoporosis Care.Current osteoporosis reports · 2021Review
- Perspectives on the non-invasive evaluation of femoral strength in the assessment of hip fracture risk.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Article
- Patient-Specific Bone Multiscale Modelling, Fracture Simulation and Risk Analysis-A Survey.Materials (Basel, Switzerland) · 2019Review
- Improving the Hip Fracture Risk Prediction Through 2D Finite Element Models From DXA Images: Validation Against 3D Models.Frontiers in bioengineering and biotechnology · 2019Article
- Article
- Sideways fall-induced impact force and its effect on hip fracture risk: a review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017Review
Corrections and comments
- Erratum issued
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Computed tomography (CT)-based finite element (FE) models may improve the current osteoporosis diagnostics and prediction of fracture risk by providing an estimate for femoral strength. However, the need for a CT scan, as opposed to the conventional use of dual-energy X-ray absorptiometry (DXA) for osteoporosis diagnostics, is considered a major obstacle. The 3D shape and bone mineral density (BMD) distribution of a femur can be reconstructed using a statistical shape and appearance model (SSAM) and the DXA image of the femur. Then, the reconstructed shape and BMD could be used to build FE models to predict bone strength. Since high accuracy is needed in all steps of the analysis, this study aimed at evaluating the ability of a 3D FE model built from one 2D DXA image to predict the strains and fracture load of human femora. Three cadaver femora were retrieved, for which experimental measurements from ex vivo mechanical tests were available. FE models were built using the SSAM-based reconstructions: using only the SSAM-reconstructed shape, only the SSAM-reconstructed BMD distribution, and the full SSAM-based reconstruction (including both shape and BMD distribution). When compared with experimental data, the SSAM-based models predicted accurately principal strains (coefficient of determination >0.83, normalized root-mean-square error <16%) and femoral strength (standard error of the estimate 1215 N). These results were only slightly inferior to those obtained with CT-based FE models, but with the considerable advantage of the models being built from DXA images. In summary, the results support the feasibility of SSAM-based models as a practical tool to introduce FE-based bone strength estimation in the current fracture risk diagnostics.
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