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While osteoporosis has been identified as one of the causative factors of fracture, atypical femoral fracture has emerged as a potential complication of bisphosphonate therapy. Atypical femoral \nfracture is prevalent among Asian women and has been attributed to morphological parameters. Age-related decreases in the morphological parameters of the femoral diaphysis, such as cortical bone thickness, cortical cross-sectional area, and the cortical index, were reported in Japanese women prior to bisphosphonate drugs being approved for treatment. Thus, in the present study, the relationships between biomechanical and morphological parameters were analyzed using a CT-based finite element method. Finite element models were constructed from 44 femurs of Japanese women aged 31?87 years using CT data. Loading conditions were set as the single-leg configuration and biomechanical parameters, maximum and minimum principal stresses, Drucker-Prager equivalent stress, maximum and minimum strains, and strain energy density were calculated in 7 zones from the \nsubtrochanteric region to distal diaphysis. Pearson\u0027s correlation coefficient test was performed to investigate relationships with morphological parameters. While absolute stresses gradually decreased from the subtrochanteric region to distal diaphysis, absolute strains markedly declined in the proximal diaphysis and were maintained at the same levels as those in the distal regions. All types of stresses and minimum principal strain in the femoral diaphysis scored higher absolute values in the high-risk group (?70 years, n = 28) than in the low-risk group (\u003c70 years, n = 16) \n(p \u003c 0.05). The distribution patterns of equivalent stress and strain energy density were similar to that of Young\u0027s modulus, except for the region of the linea aspera. All biomechanical parameters correlated with morphological parameters and correlation efficiencies, with the reciprocal of cortical bone thickness showing the strongest correlation. The present results demonstrated that biomechanical parameters may be predicted by calculating the cortical bone thickness of femurs not treated with bisphosphonates. Furthermore, strain appeared to be repressed at a low level despite differences in stress intensities among the regions by bone remodeling. This remodeling is considered to be regulated\n by Wolff\u0027s law driven by equivalent stress and strain energy densities from the proximal to distal femur. 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Reduced cortical bone thickness increases stress and strain in the female femoral diaphysis analyzed by a CT-based finite element method: Implications for the anatomical background of fatigue fracture of the femur
http://hdl.handle.net/10069/40459
http://hdl.handle.net/10069/404597c7247e1-12b8-4a1c-bef4-bc4d80eaedef
名前 / ファイル | ライセンス | アクション |
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BoRep13_100733.pdf (2.8 MB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2020-12-23 | |||||
タイトル | ||||||
タイトル | Reduced cortical bone thickness increases stress and strain in the female femoral diaphysis analyzed by a CT-based finite element method: Implications for the anatomical background of fatigue fracture of the femur | |||||
言語 | ||||||
言語 | eng | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Femur | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Biomechanical parameter | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Diaphysis | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Cortical bone | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Morphological parameter | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Atypical femoral fracture | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
著者 |
Endo, Daisuke
× Endo, Daisuke× Ogami-Takamura, Keiko× Imamura, Takeshi× Saiki, Kazunobu× Murai, Kiyohito× Okamoto, Keishi× Tsurumoto, Toshiyuki |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | The incidence of hip fractures is increasing in Japan and is high among women older than 70 years. While osteoporosis has been identified as one of the causative factors of fracture, atypical femoral fracture has emerged as a potential complication of bisphosphonate therapy. Atypical femoral fracture is prevalent among Asian women and has been attributed to morphological parameters. Age-related decreases in the morphological parameters of the femoral diaphysis, such as cortical bone thickness, cortical cross-sectional area, and the cortical index, were reported in Japanese women prior to bisphosphonate drugs being approved for treatment. Thus, in the present study, the relationships between biomechanical and morphological parameters were analyzed using a CT-based finite element method. Finite element models were constructed from 44 femurs of Japanese women aged 31?87 years using CT data. Loading conditions were set as the single-leg configuration and biomechanical parameters, maximum and minimum principal stresses, Drucker-Prager equivalent stress, maximum and minimum strains, and strain energy density were calculated in 7 zones from the subtrochanteric region to distal diaphysis. Pearson's correlation coefficient test was performed to investigate relationships with morphological parameters. While absolute stresses gradually decreased from the subtrochanteric region to distal diaphysis, absolute strains markedly declined in the proximal diaphysis and were maintained at the same levels as those in the distal regions. All types of stresses and minimum principal strain in the femoral diaphysis scored higher absolute values in the high-risk group (?70 years, n = 28) than in the low-risk group (<70 years, n = 16) (p < 0.05). The distribution patterns of equivalent stress and strain energy density were similar to that of Young's modulus, except for the region of the linea aspera. All biomechanical parameters correlated with morphological parameters and correlation efficiencies, with the reciprocal of cortical bone thickness showing the strongest correlation. The present results demonstrated that biomechanical parameters may be predicted by calculating the cortical bone thickness of femurs not treated with bisphosphonates. Furthermore, strain appeared to be repressed at a low level despite differences in stress intensities among the regions by bone remodeling. This remodeling is considered to be regulated by Wolff's law driven by equivalent stress and strain energy densities from the proximal to distal femur. The present results will promote further investigations on the contribution of morphological parameters in the femoral diaphysis to the onset of atypical femoral fracture. |
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書誌情報 |
Bone Reports 巻 13, p. 100733, 発行日 2020-11-12 |
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出版者 | ||||||
出版者 | Elsevier Inc. | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 23521872 | |||||
DOI | ||||||
関連タイプ | isIdenticalTo | |||||
識別子タイプ | DOI | |||||
関連識別子 | 10.1016/j.bonr.2020.100733 | |||||
権利 | ||||||
権利情報 | c 2020 The Authors. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/) | |||||
著者版フラグ | ||||||
出版タイプ | VoR | |||||
出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||
引用 | ||||||
内容記述タイプ | Other | |||||
内容記述 | Bone Reports, 13, art.no.100733; 2020 |