ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2018
Association of incident hip fracture with the estimated femoral strength by finite element analysis of DXA scans in the Osteoporotic Fractures in Men (MrOS) study.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 18 citations in OpenAlex.
- Fracture prediction using 3D-DXA-finite element based femoral strength: a prospective study in postmenopausal women.Bone reports · 2026Article
- The Osteoporotic Fractures in Men study (MrOS): a 25-yr landmark study of skeletal health in older men.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2026Article
- Biomechanical perspectives on image-based hip fracture risk assessment: advances and challenges.Frontiers in endocrinology · 2025Review
- The Morphology of the Femur Influences the Fracture Risk during Stumbling and Falls on the Hip-A Computational Biomechanical Study.Life (Basel, Switzerland) · 2024Article
- Finite Element Assessment of Bone Fragility from Clinical Images.Current osteoporosis reports · 2021Review
- Next-generation imaging of the skeletal system and its blood supply.Nature reviews. Rheumatology · 2019Review
- Bone Mineral Density and Bone Turnover Markers in Postmenopausal Women Subjected to an Aqua Fitness Training Program.International journal of environmental research and public health · 2019Article
- Neuro-musculoskeletal flexible multibody simulation yields a framework for efficient bone failure risk assessment.Scientific reports · 2019Article
- Are CT-Based Finite Element Model Predictions of Femoral Bone Strength Clinically Useful?Current osteoporosis reports · 2018Review
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7 authors at 4 institutions in 2 countries.
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Abstract
Finite element model can estimate bone strength better than BMD. This study used such a model to determine its association with hip fracture risk and found that the strength estimate provided limited improvement over the hip BMDs in predicting femoral neck (FN) fracture risk only.
introductionBone fractures occur only when it is loaded beyond its ultimate strength. The goal of this study was to determine the association of femoral strength, as estimated by finite element (FE) analysis of DXA scans, with incident hip fracture as a single condition or with femoral neck (FN) and trochanter (TR) fractures separately in older men.
methodsThis prospective case-cohort study included 91 FN and 64 TR fracture cases and a random sample of 500 men (14 had a hip fracture) from the Osteoporotic Fractures in Men study during a mean ± SD follow-up of 7.7 ± 2.2 years. We analysed the baseline DXA scans of the hip using a validated plane-stress, linear-elastic FE model of the proximal femur and estimated the femoral strength during a sideways fall.
resultsThe estimated strength was significantly (P < 0.05) associated with hip fracture independent of the TR and total hip (TH) BMDs but not FN BMD, and combining the strength with BMD did not improve the hip fracture prediction. The strength estimate was associated with FN fractures independent of the FN, TR and TH BMDs; the age-BMI-BMD adjusted hazard ratio (95% CI) per SD decrease of the strength was 1.68 (1.07-2.64), 2.38 (1.57, 3.61) and 2.04 (1.34, 3.11), respectively. This association with FN fracture was as strong as FN BMD (Harrell's C index for the strength 0.81 vs. FN BMD 0.81) and stronger than TR and TH BMDs (0.8 vs. 0.78 and 0.81 vs. 0.79). The strength's association with TR fracture was not independent of hip BMD.
conclusionsAlthough the strength estimate provided additional information over the hip BMDs, its improvement in predictive ability over the hip BMDs was confined to FN fracture only and limited.
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