3d finite element models reconstructed from 2d dxa images improve hip fracture prediction compared to areal bmd in mros sweden cohort

ABSTRACTBone strength is an important contributor to fracture risk. Areal bone mineral density (aBMD) derived from dual-energy X-ray absorptiometry (DXA) is used as a surrogate for bone strength in fracture risk prediction tools. 3D finite element (FE) models predict bone strength better than aBMD, but their clinical use is limited by the need for 3D computed tomography and lack of automation. We have earlier developed a method to reconstruct the 3D hip anatomy from a 2D DXA image, followed by subject-specific FE-based prediction of proximal femoral strength. In the current study, we aim to evaluate the method's ability to predict incident hip fractures in a population-based cohort (MrOS Sweden).We defined two sub-cohorts: (i)hip fracture cases and controls cohort: 120 men with a hip fracture (<10  years from baseline) and 2 controls to each hip fracture case, matched by age, height, and body mass index; (ii)fallers cohort: 86 men who had fallen the year before their hip DXA scan was acquired, 15 of which sustained a hip fracture during the following 10  years. For each participant, we reconstructed the 3D hip anatomy and predicted proximal femoral strength in 10 sideways fall configurations using FE analysis. The FE-predicted proximal femoral strength was a better predictor of incident hip fractures than aBMD for bothhip fracture cases and controls (difference in area under the receiver operating characteristics curve, ΔAUROC = 0.06) andfallers ( ΔAUROC = 0....
Source: Journal of Bone and Mineral Research - Category: Orthopaedics Authors: Tags: Research Article Source Type: research