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Skeletal assessment with finite element analysis: relevance, pitfalls and interpretation
Graeme Michael Campbell1, Claus-C Glüer
1aInstitute of Biomechanics, TUHH Hamburg University of Technology, Hamburg bSection Biomedical Imaging, Department of Radiology and Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
Current Opinion in Rheumatology
|April 5, 2017
Summary
Finite element models offer noninvasive bone strength assessment. While promising for fracture prediction and implant stability, further validation and improved modeling are needed for clinical application.
Area of Science:
- Skeletal biomechanics
- Computational modeling
- Orthopaedic research
Background:
- Finite element models (FEM) simulate bone mechanical response to loads.
- Quantitative computed tomography (QCT) data integrates bone geometry and bone mineral density (BMD) for FEM.
- FEM applications include simulating physiological/traumatic loads and orthopaedic implant behavior.
Purpose of the Study:
- Review the strengths and weaknesses of FEM in skeletal biomechanics.
- Evaluate FEM's current capabilities and limitations for bone strength assessment and fracture prediction.
- Discuss FEM applications in orthopaedic implant stability analysis.
Main Methods:
- Review of current literature on finite element models in skeletal biomechanics.
- Comparison of FEM-based strength estimations with bone mineral density (BMD) measures.
- Analysis of clinical data and validation studies for FEM in fracture prediction.
- Examination of challenges in simulating bone-implant interfaces and fracture progression.
Main Results:
- FEM provide better bone strength estimations than BMD in cadaver studies.
- Clinical data shows encouraging but inconclusive superiority of FEM over BMD for fracture prediction, potentially varying by sex and site.
- Therapeutic effects on bone strength are more pronounced in FEM than BMD, but models are validated primarily on untreated bone.
- Accurate simulation of bone-implant interface and fracture progression remains challenging.
Conclusions:
- Skeletal FEM enable noninvasive assessment of bone strength and orthopaedic implant stability.
- Enhancements in structural representation and bone-implant surface interaction modeling are crucial for future accuracy.
- Further research and validation are needed to fully realize the clinical potential of FEM in predicting fragility and guiding treatment.