ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2020
Perspectives on the non-invasive evaluation of femoral strength in the assessment of hip fracture risk.
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, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 45 citations in OpenAlex.
- Trial
- Fracture prediction using 3D-DXA-finite element based femoral strength: a prospective study in postmenopausal women.Bone reports · 2026Article
- Investigating the Influence of Limited CT Scan Coverage Using an Automated Workflow with Biofidelic Sideways Fall FE Models.Annals of biomedical engineering · 2026Article
- Bone Health in Autistic Children: Evidence from a Population-Representative Australian Cohort Study.Journal of autism and developmental disorders · 2025Article
- Gender differences in L1 vertebral strength in adults 50+ using automated CT-based finite element analysis.Scientific reports · 2025Article
- Computer-aided diagnosis for China-Japan Friendship Hospital classification of necrotic femurs using statistical shape and appearance model based on CT scans.Medical & biological engineering & computing · 2025Article
- The relationship between treatment-related changes in total hip BMD measured after 12, 18, and 24 mo and fracture risk reduction in osteoporosis clinical trials: the FNIH-ASBMR-SABRE project.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024Article
- Association between composite indices of femoral neck strength and odds of hip fracture.Archives of osteoporosis · 2024Article
- The Morphology of the Femur Influences the Fracture Risk during Stumbling and Falls on the Hip-A Computational Biomechanical Study.Life (Basel, Switzerland) · 2024Article
- Structural differences contributing to sex-specific associations between FN BMD and whole-bone strength for adult White women and men.JBMR plus · 2024Article
- Short-Term Precision and Repeatability of Radiofrequency Echographic Multi Spectrometry (REMS) on Lumbar Spine and Proximal Femur: An In Vivo Study.Journal of imaging · 2023Article
- 2D-3D reconstruction of the proximal femur from DXA scans: Evaluation of the 3D-Shaper software.Frontiers in bioengineering and biotechnology · 2023Article
- Influence of aging on mechanical properties of the femoral neck using an inverse method.Bone reports · 2022Article
- Improving the Hip Fracture Risk Prediction with a Statistical Shape-and-Intensity Model of the Proximal Femur.Annals of biomedical engineering · 2022Article
- Bringing Mechanical Context to Image-Based Measurements of Bone Integrity.Current osteoporosis reports · 2021Review
- On challenges in clinical assessment of hip fracture risk using image-based biomechanical modelling: a critical review.Journal of bone and mineral metabolism · 2021Review
- The risk factors of postoperative delirium in patients with hip fracture: implication for clinical management.BMC musculoskeletal disorders · 2021Article
- Dual-energy X-ray absorptiometry bone densitometry in pediatrics: a practical review and update.Pediatric radiology · 2021Review
- Article
- Biomechanical Computed Tomography analysis (BCT) for clinical assessment of osteoporosis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Review
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We reviewed the experimental and clinical evidence that hip bone strength estimated by BMD and/or finite element analysis (FEA) reflects the actual strength of the proximal femur and is associated with hip fracture risk and its changes upon treatment.
introductionThe risk of hip fractures increases exponentially with age due to a progressive loss of bone mass, deterioration of bone structure, and increased incidence of falls. Areal bone mineral density (aBMD), measured by dual-energy X-ray absorptiometry (DXA), is the most used surrogate marker of bone strength. However, age-related declines in bone strength exceed those of aBMD, and the majority of fractures occur in those who are not identified as osteoporotic by BMD testing. With hip fracture incidence increasing worldwide, the development of accurate methods to estimate bone strength in vivo would be very useful to predict the risk of hip fracture and to monitor the effects of osteoporosis therapies.
methodsWe reviewed experimental and clinical evidence regarding the association between aBMD and/orCT-finite element analysis (FEA) estimated femoral strength and hip fracture risk as well as their changes with treatment.
resultsFemoral aBMD and bone strength estimates by CT-FEA explain a large proportion of femoral strength ex vivo and predict hip fracture risk in vivo. Changes in femoral aBMD are strongly associated with anti-fracture efficacy of osteoporosis treatments, though comparable data for FEA are currently not available.
conclusionsHip aBMD and estimated femoral strength are good predictors of fracture risk and could potentially be used as surrogate endpoints for fracture in clinical trials. Further improvements of FEA may be achieved by incorporating trabecular orientations, enhanced cortical modeling, effects of aging on bone tissue ductility, and multiple sideway fall loading conditions.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.