Correlations between the mechanical properties, radiology and histomorphometry of human femoral bone

Initial fixation of the femoral components of total hip replacements is related to the mechanical integrity of the bone within the proximal femur. This preliminary study examined the correlations between the mechanical properties, histomorphometry, and radiology of bone core specimens taken from the proximal femora of cadavers and of patients undergoing total hip replacement surgery. Measurements and subjective assessments of the femoral bone from radiographs were shown to have poor correlation with both compressive mechanical properties and bone volume measurements. However, the mechanical properties of the bone core specimens and the histomorphometric measurements correlated well with the bone density measured by single-photon absorptiometry, indicating that this type of imaging technique may be of value in determining bone quality prior to surgery. The prediction of the mechanical properties of the proximal femur by preoperative imaging may have direct bearing on the type of femoral component to be used in total hip replacement. Preoperative assessment of bone quality would allow the surgeon to predict the likely fixation obtainable with different designs.