Fracture Prediction for the Proximal Femur Using Finite Element Models: Part II—Nonlinear Analysis

Lotz, Jeffrey C.; Cheal, E. J.; Hayes, Wilson C.

doi:10.1115/1.2895413

Cited by 114 publications

(57 citation statements)

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“…These variables direct the propagation of yielded material and the decrement of the elastic stiffness [29]. The damage plasticity model represents the inelastic behaviour of the bone by combining isotropic damaged elasticity with isotropic tensile and compressive plasticity.…”

Section: Methodsmentioning

confidence: 99%

Failure Analysis Following Osteochondroplasty for Hip Impingement in Osteoporotic and Non-Osteoporotic Bones

Jimenez-Cruz¹,

Mt²,

Cg³

et al. 2016

J Osteopor Phys Act

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Femoral osteochondroplasty is the most common treatment for femoroacetabular impingement (FAI). The risk of femoral neck fracture is increased following surgery and increases further when the bone is osteoporotic. The current requirement to undertake osteochondroplasty on patients with osteoporosis is forecast to increase, however, the effect of osteoporosis on the risk of postoperative fracture is currently unknown.We developed three three-dimensional (3D) finite element models using computerised tomography (CT) scan data for a hip with cam-type impingement and used them to investigate the association between osteoporosis and the increased possibility of femoral neck fracture after femoral osteochondroplasty.Femoral osteochondroplasty was performed "virtually" on the intact hip model to two different resection depths, a 'standard' (6mm) and a 'critical' resection (12mm) depth, corresponding to 18% and 36% of the overall femoral neck diameter, respectively. Cortical and trabecular bone were included in the intact and resection hip models, and material properties representing both non-osteoporotic and osteoporotic cases employed, overall, 18 scenarios were analysed. Loading corresponding to "descending stairs" and "stumbling" activities were applied in the models enabling fracture propensity to be estimated.Our model predicted that fracture propagation can occur in the bone of osteoporotic patients following osteochondroplasty during typical daily activities, such as descending stairs. 3The level of damage increases significantly when patients are subjected to high load conditions and activities, even in non-osteoporotic patients, indicating an increased likelihood of fracture occurring. In the "stumbling activity" simulation, osteoporotic trabecular bone damage volume approached 50% for the 6mm resection, rising to 70% at a resection depth of 12mm. The corresponding rise in osteoporotic cortical bone volume damage was from 6% to 10%.Our findings support the recommendation for protected weight-bearing in patients in the postoperative phase and suggest an extended period of protected weight-bearing in osteoporotic patients could be considered.

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Section: Methodsmentioning

confidence: 99%

Failure Analysis Following Osteochondroplasty for Hip Impingement in Osteoporotic and Non-Osteoporotic Bones

Jimenez-Cruz¹,

Mt²,

Cg³

et al. 2016

J Osteopor Phys Act

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show abstract

“…As CT attenuations only provide a scalar value at each point, many studies assume isotropic elasticity (164)(165)(166)(167)(168)(169), although anisotropic material properties have also been implemented using information within the voxel (170). The elastic moduli for early isotropic models have been homogeneous (171)(172)(173), but more recent studies have used inhomogeneous materials (8,164,165,170,174-178) as they have been found to be more accurate than the models using homogeneous material properties (9,179,180).…”

Section: The Finite Element Methodsmentioning

confidence: 99%

Experimental validation of finite element predicted bone strain in the human metatarsal

Fung

Loundagin

Edwards

2017

Journal of Biomechanics

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The objective of this study was to verify and validate a finite element modeling routine for the human metatarsal, which is a common location for stress fractures. Experimental strain measurements on 33 human cadaveric metatarsals subject to cantilever bending were compared with strain predictions from finite element (FE) models generated from computed tomography images. For the material property assignment of the FE models, a published density-elasticity relationship was compared with density-elasticity equations developed using optimization techniques. The correlations between the measured and predicted and predicted strains were very high (r 2 ≥0.94) for all of the density-elasticity equations. However, the utilization of an optimized density-elasticity equation improved the accuracy of the finite element models, reducing the maximum error between measured and predicted strains by 10% to 20%. The finite element modeling routine could be used for investigating potential interventions to minimize metatarsal strains and the occurrence of metatarsal stress fractures.iii

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“…Lotz et al investigated the predictive value for fracture load of linear (Lotz et al 1991a) and nonlinear (Lotz et al 1991b) models. In addition, they studied the predictive value for femoral fracture load of stress-and strain-based theories in linear models (Lotz et al 1991a).…”

Section: (A ) Fe Meshmentioning

confidence: 99%

Multi-level patient-specific modelling of the proximal femur. A promising tool to quantify the effect of osteoporosis treatment

Lenaerts

Lenthe

2009

Phil. Trans. R. Soc. A.

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Preventing femoral fractures is an important goal in osteoporosis research. In order to evaluate a person's fracture risk and to quantify response to treatment, bone competence is best assessed by bone strength. Finite-element (FE) modelling based on medical imaging is considered a very promising technique for the assessment of in vivo femoral bone strength. Over the past decades, a number of different FE models have been presented focusing on the effect of several methodological aspects, such as mesh type, material properties and loading conditions, on the precision and accuracy of these models. In this paper, a review of this work is presented. We conclude that moderate to good predictions can be made, especially when the models are tuned to specific loading scenarios. However, there is room for improvement when multiple loading conditions need to be evaluated. We hypothesize that including anisotropic material properties is the first target. As a proof of the concept, we demonstrate that the main orientation of the femoral bone structure can be calculated from clinical computed tomography scans. We hypothesize that this structural information can be used to estimate the anisotropic bone material properties, and that in the future this could potentially lead to a greater predictive value of FE models for femoral bone strength.

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Fracture Prediction for the Proximal Femur Using Finite Element Models: Part II—Nonlinear Analysis

Cited by 114 publications

References 0 publications

Failure Analysis Following Osteochondroplasty for Hip Impingement in Osteoporotic and Non-Osteoporotic Bones

Failure Analysis Following Osteochondroplasty for Hip Impingement in Osteoporotic and Non-Osteoporotic Bones

Experimental validation of finite element predicted bone strain in the human metatarsal

Multi-level patient-specific modelling of the proximal femur. A promising tool to quantify the effect of osteoporosis treatment

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