WHO to Release Absolute Fracture Risk Index

Accurate assessment of hip fracture risk is very important to prevent hip fracture and to monitor the effect of a treatment. A subject-specific QCT-based finite element model was constructed to assess hip fracture risk at the critical locations of femur during the single-leg stance and the sideways fall. The aim of this study was to improve the prediction of hip fracture risk by introducing a novel failure criterion to more accurately describe bone failure mechanism. Hip fracture risk index was defined using cross-section strain energy, which is able to integrate information of stresses, strains, and material properties affecting bone failure. It was found that the femoral neck and the intertrochanteric region have higher fracture risk than other parts of the femur, probably owing to the larger content of cancellous bone in these regions. The study results also suggested that women are more prone to hip fracture than men. The findings in this study have a good agreement with those clinical observations reported in the literature. The proposed hip fracture risk index based on strain energy has the potential of more accurate assessment of hip fracture risk. However, experimental validation should be conducted before its clinical applications.

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Effect of Loading Direction and Bone Density Distribution in Assessing Hip Fracture via Finite Element Analysis

Volume 5: Biomedical and Biotechnology ◽

10.1115/imece2020-24028 ◽

2020 ◽

Author(s):

Rabina Awal ◽

Tanvir R. Faisal

Keyword(s):

Hip Fracture ◽

Bone Density ◽

Fracture Risk ◽

Risk Index ◽

Transverse Plane ◽

Coronal Plane ◽

Mineral Density ◽

Femoral Neck Axis ◽

Loading Direction ◽

The Impact

Abstract An accurate assessment of hip fracture risk requires a proper consideration of parameters affecting the fracture. In general, hip fracture is affected by bone morphology, bone mineral Density (BMD), and load amount. Hip fracture is an outcome of the interaction of all those parameters including loading directions. Assessing the effect of the parameters individually may not correctly reflect the root cause of the hip fracture. Hence, this research aims at analyzing the significance of parameters and their interaction. A multivariate regression model was used considering bone density (ρash), different loading directions during sideways fall, represented by load angle (α) on the coronal plane and angle (β) on the transverse plane as independent parameters and Fracture Risk Index (FRI) as a dependent parameter. The statistical results showing the significant value of 0.7321 for α, and 0.0001 for β and ρash indicates that the effect of loading direction about femoral shaft on the coronal plane (α) does not have impact on fracture risk while loading direction about femoral neck axis on the transverse plane (β) and ρash have the significant impact. Furthermore, the analysis of the interaction of parameters shows that the impact of β on fracture risk may depends more on bone density as the significance of interaction of β and ρash is 0.0001.

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Bone Mineral Density and Fracture Risk Assessment to Optimize Prosthesis Selection in Total Hip Replacement

Computational and Mathematical Methods in Medicine ◽

10.1155/2015/162481 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 13

Author(s):

Þröstur Pétursson ◽

Kyle Joseph Edmunds ◽

Magnús Kjartan Gíslason ◽

Benedikt Magnússon ◽

Gígja Magnúsdóttir ◽

...

Keyword(s):

Bone Mineral Density ◽

Fracture Risk ◽

Total Hip Replacement ◽

Bone Mineral ◽

Hip Replacement ◽

Risk Index ◽

Patient Specific ◽

Mineral Density ◽

Total Hip ◽

And Gender

The variability in patient outcome and propensity for surgical complications in total hip replacement (THR) necessitates the development of a comprehensive, quantitative methodology for prescribing the optimal type of prosthetic stem: cemented or cementless. The objective of the research presented herein was to describe a novel approach to this problem as a first step towards creating a patient-specific, presurgical application for determining the optimal prosthesis procedure. Finite element analysis (FEA) and bone mineral density (BMD) calculations were performed with ten voluntary primary THR patients to estimate the status of their operative femurs before surgery. A compilation model of the press-fitting procedure was generated to define a fracture risk index (FRI) from incurred forces on the periprosthetic femoral head. Comparing these values to patient age, sex, and gender elicited a high degree of variability between patients grouped by implant procedure, reinforcing the notion that age and gender alone are poor indicators for prescribing prosthesis type. Additionally, correlating FRI and BMD measurements indicated that at least two of the ten patients may have received nonideal implants. This investigation highlights the utility of our model as a foundation for presurgical software applications to assist orthopedic surgeons with selecting THR prostheses.

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Forecasting Postflight Hip Fracture Probability Using Probabilistic Modeling

Journal of Biomechanical Engineering ◽

10.1115/1.4041164 ◽

2018 ◽

Vol 141 (1) ◽

Author(s):

Beth E. Lewandowski ◽

Jerry G. Myers

Keyword(s):

Hip Fracture ◽

Impact Load ◽

Risk Index ◽

Fracture Probability ◽

Mineral Density ◽

Fitness For Duty ◽

Bone Loss Rate ◽

Fracture Risk Index ◽

Insight Into ◽

Exercise Countermeasures

A probabilistic model predicts hip fracture probability for postflight male astronauts during lateral fall scenarios from various heights. A biomechanical representation of the hip provides impact load. Correlations relate spaceflight bone mineral density (BMD) loss and postflight BMD recovery to bone strength (BS). Translations convert fracture risk index (FRI), the ratio of applied load (AL) to BS, to fracture probability. Parameter distributions capture uncertainty and Monte Carlo simulations provide probability outcomes. The fracture probability for a 1 m fall 0 days postflight is 15% greater than preflight and remains 6% greater than pre-flight at 365 days postflight. Probability quantification provides insight into how spaceflight induced BMD loss affects fracture probability. A bone loss rate reflecting improved exercise countermeasures and dietary intake further reduces the postflight fracture probability to 6% greater than preflight at 0 days postflight and 2% greater at 365 days postflight. Quantification informs assessments of countermeasure effectiveness. When preflight BMD is one standard deviation below mean astronaut preflight BMD, fracture probability at 0 days postflight is 34% greater than the preflight fracture probability calculated with mean BMD and 28% greater at 365 days postflight. Quantification aids review of astronaut BMD fitness for duty standards. Increases in postflight fracture probability are associated with an estimated 18% reduction in postflight BS. Therefore, a 0.82 deconditioning coefficient modifies force application limits for crew vehicles.

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