Are DXA/aBMD and QCT/FEA Stiffness and Strength Estimates Sensitive to Sex and Age?

Dual X-ray absorptiometry (DXA) measures areal bone mineral density (aBMD) by simplifying a complex 3D bone structure to a 2D projection and is not equally effective for explaining fracture strength in women and men. Unlike DXA, subject-specific quantitative computed tomography-based finite element...

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Bibliographic Details
Published in:Annals of biomedical engineering Vol. 45; no. 12; pp. 2847 - 2856
Main Authors: Rezaei, Asghar, Giambini, Hugo, Rossman, Timothy, Carlson, Kent D., Yaszemski, Michael J., Lu, Lichun, Dragomir-Daescu, Dan
Format: Journal Article
Language:English
Published: New York Springer US 01.12.2017
Springer Nature B.V
Subjects:
Absorptiometry
Absorptiometry, Photon - methods
Adult
Age
Aged
Aged, 80 and over
Aging - physiology
Biochemistry
Biological and Medical Physics
Biomedical and Life Sciences
Biomedical Engineering and Bioengineering
Biomedical materials
Biomedicine
Biophysics
Bone mineral density
Cadaver
Cadavers
Calcification, Physiologic - physiology
Classical Mechanics
Compressive Strength - physiology
Computed tomography
Computer Simulation
Dual energy X-ray absorptiometry
Elastic Modulus - physiology
Estimates
Female
Femur
Femur - diagnostic imaging
Femur - physiology
Finite Element Analysis
Finite element method
Forecasting
Fracture strength
Fractures
Hip
Humans
Male
Mechanical properties
Middle Aged
Models, Biological
Position measurement
Reproducibility of Results
Sensitivity analysis
Sensitivity and Specificity
Sex
Sex Characteristics
Statistical analysis
Stiffness
Stress, Mechanical
Surgical implants
Tensile Strength - physiology
Tomography, X-Ray Computed - methods
Aging
Sex differences
Hip fracture
Finite element analysis
Bone biomechanics
ISSN:0090-6964, 1573-9686, 1573-9686
Online Access:Get full text
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Summary:Dual X-ray absorptiometry (DXA) measures areal bone mineral density (aBMD) by simplifying a complex 3D bone structure to a 2D projection and is not equally effective for explaining fracture strength in women and men. Unlike DXA, subject-specific quantitative computed tomography-based finite element analysis (QCT/FEA) estimates fracture strength using 3D bone mineral distribution and geometry. By using experimentally-measured femoral stiffness and strength from a one hundred sample cadaveric cohort that included variations in sex and age, we wanted to determine if QCT/FEA estimates were able to better predict the experimental variations than DXA/aBMD. For each femur, DXA/aBMD was assessed and a QCT/FEA model was developed to estimate femoral stiffness and strength. Then, the femur was mechanically tested to fracture in a sideways fall on the hip position to measure stiffness and strength. DXA/aBMD and QCT/FEA estimates were compared for their sensitivity to sex and age with multivariate statistical analyses. When comparing the measured data with DXA/aBMD predictions, both age and sex were significant ( p  ≤ 0.0398) for both femoral stiffness and strength. However, QCT/FEA predictions of stiffness and strength showed sex was insignificant ( p  ≥ 0.23). Age was still significant ( p  ≤ 0.0072). These results indicate that QCT/FEA, unlike DXA/aBMD, accounted for bone differences due to sex.
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ISSN:0090-6964
1573-9686
1573-9686
DOI:10.1007/s10439-017-1914-5