Mechanical strength of tibial trabecular bone evaluated by X-ray computed tomography

The prospects for the use of quantitative computed tomography (QCT) for evaluation of mechanical properties of tibial trabecular bone were investigated. Computed tomography (CT) data from the proximal tibial epi- and metaphysis of six human cadaver knees were correlated with mechanical data obtained from compression tests and penetration strength measurements. In addition CT and intraoperative penetration data were compared in 20 patients. If spatial agreement between CT and mechanical measurement sites is optimized, close correlations are found between the relative linear attenuation coefficient determined by CT and the ultimate strength (r = 0.84), the yield strength (r = 0.85), the elastic modulus (r = 0.78), the ultimate energy absorption (r = 0.83), the yield energy absorption (r = 0.81), and the penetration strength (r = 0.82). It is concluded that these correlations are sufficient to make QCT a valuable tool for non-invasive evaluation of the spatial distribution of bone properties in several clinical applications.