Finite element analysis for prediction of bone strength

Area of Science:

• Biomechanics
• Medical Imaging
• Orthopedics

Background:

• Finite element (FE) analysis has been used for decades to simulate bone mechanical behavior.
• Previous validation studies focused on specific anatomical sites and loading conditions.
• Osteoporotic fractures occur at the distal radius, vertebrae, and proximal femur.

Purpose of the Study:

• To review the predictability of human bone strength at major osteoporotic fracture sites using FE analysis.
• To compare the performance of FE analysis based on quantitative CT (QCT) with current densitometric standards (bone mineral content, BMD, aBMD).

Main Methods:

• QCT-based FE models were developed for distal radii, vertebral sections, and proximal femora.
• Models simulated experimental boundary conditions for monotonic axial compression and side loading.
• FE predictions of bone strength were compared against experimental data.

Main Results:

• FE analysis demonstrated the lowest errors and highest correlations in predicting experimental bone strength across all sites.
• FE predictions were superior for the peripheral skeleton (using high-resolution peripheral CT) compared to the axial skeleton (using whole-body QCT).
• Areal BMD (aBMD) performance varied with loading mode, being inferior to FE in axial compression but comparable in femoral side loading.

Conclusions:

• FE models provide the most reliable surrogates for predicting bone strength at major osteoporotic fracture sites.
• The accuracy of FE analysis is influenced by CT image resolution and anatomical site.
• FE analysis offers a more robust approach to bone strength assessment than traditional densitometry.