To what extent can linear finite element models of human femora predict failure under stance and fall loading configurations?

Schileo, Enrico; Balistreri, Luca; Grassi, Lorenzo; Cristofolini, Luca; Taddei, Fulvia

doi:10.1016/j.jbiomech.2014.08.024

Cited by 131 publications

(119 citation statements)

References 40 publications

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“…from the previous studies [22,28] were used in the present study. Force and restraining BCs were applied through the femoral head and trochanter-protecting polymethyl methacrylate (PMMA) caps, and aluminum distal pot (Fig.…”

Section: Fe Model Constructionmentioning

confidence: 99%

“…The maximum error in octant stress (described in Section 2.4) was estimated based on the converged solution that was obtained by extrapolating the results from the 3 mm, 2 mm, 1. [22], and 2 GPa [22] were set for the cortical, trabecular bone, the aluminum distal pot, and the protecting PMMA caps, respectively. Poisson's ratio was assumed as 0.33 [29][30][31] for all materials.…”

Section: Fe Model Constructionmentioning

confidence: 99%

“…However, the influence of this exercise-induced structural benefit on femoral neck strength in the sideways fall was not examined. Several FE modeling studies have been conducted to obtain a better understanding of the hip fracture mechanism [3,6,9,[11][12][13][18][19][20][21][22]. To the best of our knowledge, however, no FE modeling study has so far been conducted to investigate the influence of specific exercise loading…”

Section: Introductionmentioning

confidence: 99%

“…The force described above was then applied to the entire upper face of the femoral head cap at a defined angle while the trochanter cap was restrained in the direction of the force ( Fig. 2) [22]. The femoral head and trochanter caps covered a depth of 5 mm of the femoral head and the lateral side of the trochanter [6].…”

mentioning

confidence: 99%

“…This allowed nodes at the hinge-axis to freely rotate in the quasi-frontal plane, while all other degrees of freedom were constrained [22,28].…”

mentioning

confidence: 99%

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Exercise loading history and femoral neck strength in a sideways fall: A three-dimensional finite element modeling study

Abe

Narra

Nikander

et al. 2016

Bone

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Section: Fe Model Constructionmentioning

confidence: 99%

Section: Fe Model Constructionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

“…This allowed nodes at the hinge-axis to freely rotate in the quasi-frontal plane, while all other degrees of freedom were constrained [22,28].…”

mentioning

confidence: 99%

See 3 more Smart Citations

Exercise loading history and femoral neck strength in a sideways fall: A three-dimensional finite element modeling study

Abe

Narra

Nikander

et al. 2016

Bone

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The influence of loading configurations on numerical evaluation of failure mechanisms in an uncemented femoral prosthesis

Mathai

Gupta

2020

Numer Methods Biomed Eng

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The clinical relevance of numerical predictions of failure mechanisms in femoral prosthesis could be impaired due to simplification of musculoskeletal loading. This study investigated the extent to which loading configurations affect the preclinical analysis of an uncemented femoral implant. Patient‐specific, CT‐scan based FE models of intact and implanted femurs were developed and analysed using three loading configurations, which comprised of load cases representing daily activities. First loading configuration consisted of two load cases, each of walking and stair climbing. The second consisted of more number of load cases for each of these activities. The third included load cases of additional activities of standing up and sitting down. Failure criteria included maximum principal strains, interface debonding, implant‐bone relative displacement and adaptive bone remodelling. Simplified loading configurations led to a reduction (100‐1500 με) around cortical principal strains. The area prone to interface debonding were observed in the proximo‐medial part of implant and was maximum when all activities were considered. This area was reduced by 35%, when simplified loading configurations were chosen. Interfacial area of 88%‐96% experienced implant‐bone relative displacements below 40 μm; however maximum of 110 μm was observed at the calcar region. Lack of consideration of variety of activities overestimated (30%‐50%) bone resorption around the lateral part of the implant; hence, these bone remodelling results were less clinically relevant. Considering a variety daily activities along with an adequate number of load cases for each activity seemed necessary for pre‐clinical evaluations of reconstructed femur.

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3D Finite Element Models Reconstructed From 2D Dual‐Energy X‐Ray Absorptiometry (DXA) Images Improve Hip Fracture Prediction Compared to Areal BMD in Osteoporotic Fractures in Men (MrOS) Sweden Cohort

Grassi

Väänänen

Jehpsson

et al. 2023

J of Bone & Mineral Res

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Bone strength is an important contributor to fracture risk. Areal bone mineral density (aBMD) derived from dual‐energy X‐ray absorptiometry (DXA) is used as a surrogate for bone strength in fracture risk prediction tools. 3D finite element (FE) models predict bone strength better than aBMD, but their clinical use is limited by the need for 3D computed tomography and lack of automation. We have earlier developed a method to reconstruct the 3D hip anatomy from a 2D DXA image, followed by subject‐specific FE‐based prediction of proximal femoral strength. In the current study, we aim to evaluate the method's ability to predict incident hip fractures in a population‐based cohort (Osteoporotic Fractures in Men [MrOS] Sweden). We defined two subcohorts: (i) hip fracture cases and controls cohort: 120 men with a hip fracture (<10 years from baseline) and two controls to each hip fracture case, matched by age, height, and body mass index; and (ii) fallers cohort: 86 men who had fallen the year before their hip DXA scan was acquired, 15 of which sustained a hip fracture during the following 10 years. For each participant, we reconstructed the 3D hip anatomy and predicted proximal femoral strength in 10 sideways fall configurations using FE analysis. The FE‐predicted proximal femoral strength was a better predictor of incident hip fractures than aBMD for both hip fracture cases and controls (difference in area under the receiver operating characteristics curve, ΔAUROC = 0.06) and fallers (ΔAUROC = 0.22) cohorts. This is the first time that FE models outperformed aBMD in predicting incident hip fractures in a population‐based prospectively followed cohort based on 3D FE models obtained from a 2D DXA scan. Our approach has potential to notably improve the accuracy of fracture risk predictions in a clinically feasible manner (only one single DXA image is needed) and without additional costs compared to the current clinical approach. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

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To what extent can linear finite element models of human femora predict failure under stance and fall loading configurations?

Cited by 131 publications

References 40 publications

Exercise loading history and femoral neck strength in a sideways fall: A three-dimensional finite element modeling study

Exercise loading history and femoral neck strength in a sideways fall: A three-dimensional finite element modeling study

The influence of loading configurations on numerical evaluation of failure mechanisms in an uncemented femoral prosthesis

3D Finite Element Models Reconstructed From 2D Dual‐Energy X‐Ray Absorptiometry (DXA) Images Improve Hip Fracture Prediction Compared to Areal BMD in Osteoporotic Fractures in Men (MrOS) Sweden Cohort

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