Difference in femoral head and neck material properties between osteoarthritis and osteoporosis

Sun, Shih‐Sheng; Ma, Hsiao-Li; Liu, Chien-Lin; Huang, Chang‐Hung; Cheng, Cheng‐Kung; Wei, Hung-Wen

doi:10.1016/j.clinbiomech.2007.11.018

Cited by 49 publications

(43 citation statements)

References 21 publications

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“…21 Similarly, the neck-shaft angle can be considered to be normal. 22 The head diameter falls in the middle of the range of head diameters reported by Asala et al 23 The average BMD of the femoral head (107 mg/cm 3 , quantitative CT density) is slightly greater than the mean (182 mg/cm 3 ) minus two standard deviations (SD equal to 45 mg/cm 3 ) obtained from the hip fracture group in the study by Bousson et al 15 The average elastic modulus of the head, obtained by converting the average BMD using the density-elasticity relationship, is within the range of values reported by Sun et al 24 Our average modulus might be slightly greater than the values published there because we included, as did Bousson et al, the cortical shell in the averaging.…”

Section: Discussionmentioning

confidence: 56%

The importance of lag screw position for the stabilization of trochanteric fractures with a sliding hip screw: A subject‐specific finite element study

Goffin

Pankaj

Simpson

2012

Journal Orthopaedic Research

116

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Using finite element analysis, we compared the biomechanical performance of a CT scan-based three-part trochanteric fracture model (31-A2 in the AO classification) stabilized with a sliding hip screw for nine different positions of the lag screw (3 Â 3 arrangement, from anterior to posterior and from inferior to superior). Our results showed that the volume of bone susceptible to yielding in the head and neck region is the lowest for inferior positions and increases as the lag screw is moved superiorly. Overall, for this specific subject, the models less likely to lead to cut-out are the ones corresponding to inferior middle and inferior posterior positions of the lag screw. In our study, the tip-apex distance (TAD) was anti-correlated with the risk of cut-out, as quantified by the volume of bone susceptible to yielding, which suggests that a TAD >25 mm cannot be considered to be an accurate predictor of lag screw cut-out. Further clinical studies investigating lag screw cut-out should attempt to find more reliable predictors of cut-out that should better reflect the biomechanics and subject-specificity of the femoral head. ß

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Section: Discussionmentioning

confidence: 56%

The importance of lag screw position for the stabilization of trochanteric fractures with a sliding hip screw: A subject‐specific finite element study

Goffin

Pankaj

Simpson

2012

Journal Orthopaedic Research

116

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“…In previous studies, the expression of MMP-13 was observed to be markedly increased in patients with OA (2,4). Osteoporosis (OP) is a disorder characterized by reduced bone mass, leading to diminished physical bone strength and increased susceptibility to fracture (5). OA and OP are the most common musculoskeletal disorders among elderly populations, and are associated with estrogen deficiency (6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Effects of ultrasound on estradiol level, bone mineral density, bone biomechanics and matrix metalloproteinase-13 expression in ovariectomized rabbits

Xia

Guo

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to observe the effect of ultrasound (US) on estradiol level, bone mineral density (BMD), bone biomechanics and matrix metalloproteinase-13 (MMP-13) expression in ovariectomized (OVX) rabbits. A total of 28 virgin New Zealand white rabbits were randomly assigned into the following groups: Control (control group), ovariectomy (OVX group), ovariectomy with ultrasound therapy (US group) and ovariectomy with estrogen replacement therapy group (ERT group). At 8 weeks after ovariectomy, the US group received ultrasound treatment while the ERT group were orally treated with conjugated estrogens, and the control and OVX groups remained untreated. The estradiol level, BMD and bone biomechanics, cartilage histology and the MMP-13 expression were analyzed after the intervention. The results indicate that the US treatment increased estradiol level, BMD and bone biomechanical function. Furthermore, the US treatment appeared to improve the recovery of cartilage morphology and decreased the expression of MMP-13 in OVX models. Furthermore, the results suggest that 10 days of US therapy was sufficient to prevent the reduction of estradiol, BMD and bone biomechanical function, to protect osteoarthritis cartilage structure, and to reduce MMP-13 transcription and expression in OVX rabbits. Therefore, US treatment may be a potential treatment for postmenopausal osteoarthritis and osteoporosis.

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“…To help the reader to associate the present model's predictions to clinical practice, it is noted that the predicted maximum periprosthetic BMD losses in the three implants simulated was 10-20%, tuned to correspond with mean clinical measurements. More marked changes may result from comorbidities such as osteoporosis, which has been reported to produce a BMD loss in the region of 45-50% in comparison to osteoarthritic individuals (Sun et al 2008). More varied, and more extreme changes would be observed as a result of osteolytic bone destruction, potentially requiring revision surgery if compromising implant stability (Della Valle and Paprosky 2004).…”

Section: Discussionmentioning

confidence: 99%

Activity intensity, assistive devices and joint replacement influence predicted remodelling in the proximal femur

Dickinson

2015

Biomech Model Mechanobiol

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Bone morphology and density changes are commonly observed following joint replacement, and may contribute to the risks of implant loosening and periprosthetic fracture, and reduce the available bone stock for revision surgery. This study was presented in the "Bone and Cartilage Mechanobiology across the scales" WCCM symposium to review the development of remodelling prediction methods and to demonstrate simulation of adaptive bone remodelling around hip replacement femoral components, incorporating intrinsic (prosthesis) and extrinsic (activity and loading) factors.An iterative bone remodelling process was applied to finite element models of a femur implanted with a cementless THR (total hip replacement) and a hip resurfacing implant. Previously developed for a cemented THR implant, this modified process enabled the influence of pre-to postoperative changes in patient activity and joint loading to be evaluated. A control algorithm used identical pre-and postoperative conditions, and the predicted extents and temporal trends of remodelling were measured by generating virtual x-rays and DXA scans.The modified process improved qualitative and quantitative remodelling predictions for both the cementless THR and resurfacing implants, but demonstrated the sensitivity to DXA scan region definition and appropriate implant-bone position and sizing. Predicted remodelling in the intact femur in response to changed activity and loading demonstrated that in this simplified model, although the influence of the extrinsic effects were important, the mechanics of implantation were dominant. This study supports the application of predictive bone remodelling as one element in the range of physical and computational studies, which should be conducted in the pre-clinical evaluation of new prostheses.

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Difference in femoral head and neck material properties between osteoarthritis and osteoporosis

Cited by 49 publications

References 21 publications

The importance of lag screw position for the stabilization of trochanteric fractures with a sliding hip screw: A subject‐specific finite element study

The importance of lag screw position for the stabilization of trochanteric fractures with a sliding hip screw: A subject‐specific finite element study

Effects of ultrasound on estradiol level, bone mineral density, bone biomechanics and matrix metalloproteinase-13 expression in ovariectomized rabbits

Activity intensity, assistive devices and joint replacement influence predicted remodelling in the proximal femur

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