Assessing Bone Quality in Terms of Bone Mineral Density, Buckling Ratio and Critical Fracture Load
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Background: Bone mineral density (BMD) is used as a sole parameter in the diagnosis ofosteoporosis. Due to the ease of acquirement of BMD, clinical diagnosis still involves itsusage although the limitations of BMD are quite well-established. Therefore, this prelim-inary study hoped to reduce the errors introduced by BMD alone by incorporating geo-metric and structural predictors simultaneously to observe if strength was implicitly de-pendent on the geometry and BMD. Hence, we illustrated the triadic relationship be-tween BMD, buckling ratio (BR) and critical fracture load (Fcr). Methods: The geometricpredictor was the BR as it involves both the changes in the periosteum and the corticalthickness. Also, structural changes were monitored by finite element (FE) analysis–pre-dicted Fcr. These BR and Fcr measurements were plotted with their respective femoralneck BMD values in elderly female patients (n=6) in a 3-year follow-up study, treatedwith ibandronate. Results: In all the three-dimensional plots (baseline, mid and finalyear), high Fcrvalues were found at regions containing high BMD and low BR values. Quan-titatively, this was also proven where an averaged highest Fcracross the three years hada relatively higher BMD (46%) and lower BR (19%) than that of the averaged lowest Fcr. The dependence of FE predicted strength on both the geometry and bone density wasillustrated. Conclusions: We conclude that use of triadic relationships for the evaluationof osteoporosis and hip fractures with the combination of strength, radiology-derivedBR and bone density will lay the foundation for more accurate predictions in the future.
Abstract
Background: Bone mineral density (BMD) is used as a sole parameter in the diagnosis ofosteoporosis. Due to the ease of acquirement of BMD, clinical diagnosis still involves itsusage although the limitations of BMD are quite well-established. Therefore, this prelim-inary study hoped to reduce the errors introduced by BMD alone by incorporating geo-metric and structural predictors simultaneously to observe if strength was implicitly de-pendent on the geometry and BMD. Hence, we illustrated the triadic relationship be-tween BMD, buckling ratio (BR) and critical fracture load (Fcr). Methods: The geometricpredictor was the BR as it involves both the changes in the periosteum and the corticalthickness. Also, structural changes were monitored by finite element (FE) analysis–pre-dicted Fcr. These BR and Fcr measurements were plotted with their respective femoralneck BMD values in elderly female patients (n=6) in a 3-year follow-up study, treatedwith ibandronate. Results: In all the three-dimensional plots (baseline, mid and finalyear), high Fcrvalues were found at regions containing high BMD and low BR values. Quan-titatively, this was also proven where an averaged highest Fcracross the three years hada relatively higher BMD (46%) and lower BR (19%) than that of the averaged lowest Fcr. The dependence of FE predicted strength on both the geometry and bone density wasillustrated. Conclusions: We conclude that use of triadic relationships for the evaluationof osteoporosis and hip fractures with the combination of strength, radiology-derivedBR and bone density will lay the foundation for more accurate predictions in the future.
참고문헌 (16)
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