Neuro-musculoskeletal flexible multibody simulation yields a framework for efficient bone failure risk assessment

Area of Science:

• Biomechanics
• Computational modeling
• Orthopedics

Background:

• Fragility fractures represent a significant socioeconomic burden.
• Existing methods lack non-invasive, computationally efficient tools for fracture risk assessment integrating neuro-musculoskeletal dynamics.

Purpose of the Study:

• To introduce a novel computational workflow for early bone fracture risk assessment.
• To quantify bone strength using patient-specific neuro-musculoskeletal dynamics and finite-element models.

Main Methods:

• Integration of modally-reduced, quantitative CT-based finite-element models into neuro-musculoskeletal flexible multibody simulation (NfMBS).
• Quantification of bone strength via osteogenic stresses and strains under physiological loading.
• Non-invasive, computationally efficient dynamic analysis using sparse clinical data.

Main Results:

• Experimental validation on a human femur specimen confirmed workflow accuracy.
• Squat simulation completed in 38s CPU-time.
• A 31.4% increase in fracture-associated strain was observed with 16% cortical and 33% trabecular bone mineral density loss, indicating elevated hip fracture risk.

Conclusions:

• The developed workflow enables non-invasive, computationally efficient fracture risk assessment.
• It integrates NfMBS and bone mineral density measurements for optimized risk evaluation.
• This tool can provide clinicians with decision-making guidance for managing fracture risk.