Femoral neck shape and the spatial distribution of its mineral mass varies with its size: Clinical and biomechanical implications

Jones, Anthony; Welsh, F.; Knackstedt, Mark; Seeman, Ego

doi:10.1016/j.bone.2005.03.019

Cited by 75 publications

(48 citation statements)

References 30 publications

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“…However, the heterogeneity in regional growth that produces the diversity in size, shape, and distribution of bone mass along and around the perimeter of a bone also may contribute to the site and sex specificity of fracture incidences. (4,5) For example, lengthening of a long bone is achieved by growth at the proximal and distal growth plates, but 90% of the increase in radial length and only 30% of the increase in tibial length occur at the distal growth plate during puberty. (6,7) Thus the distal metaphysis undergoes more rapid modeling and remodeling at the radius than at the tibia.…”

Section: Introductionmentioning

confidence: 99%

Rapid growth produces transient cortical weakness: A risk factor for metaphyseal fractures during puberty

Wang

Iuliano-Burns

et al. 2010

Journal of Bone and Mineral Research

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Fractures of the distal radius in children have a similar incidence to that found in postmenopausal women but occur more commonly in boys than in girls. Fractures of the distal tibia are uncommon in children and show no sex specificity. About 90% of lengthening of the radius but only 30% of lengthening of the tibia during puberty occur at the distal growth plate. We speculated that more rapid modeling at the distal radial metaphysis results in a greater dissociation between growth and mineral accrual than observed at the distal tibia. We measured the macro-and microarchitecture of the distal radial and tibial metaphysis using high-resolution peripheral quantitative computed tomography in a cross-sectional study of 69 healthy boys and 60 healthy girls aged from 5 to 18 years. Bone diameters were larger but total volumetric bone mineral density (vBMD) was lower at the distal radius (not at the distal tibia) by 20% in boys and by 15% in girls at Tanner stage III than in children of the same sex at Tanner stage I (both p < .05). In boys at Tanner stage III, total vBMD was lower because the larger radial total cross-sectional area (CSA) had a thinner cortex with lower vBMD than in boys at Tanner stage I. In girls at Tanner stage III, the larger total radial CSA was not associated with a difference in cortical thickness or cortical vBMD relative to girls in Tanner stage I. Cortical thickness and density at both sites in both sexes after Tanner stage III were greater than in younger children. Trabecular bone volume fraction (BV/TV) was higher in boys than in girls at both sites and more so after puberty because trabeculae were thicker in more mature boys but not in girls. There was no sex-or age-related differences in trabecular number at either site. We infer that longitudinal growth outpaces mineral accrual in both sexes at the distal radius, where bone grows rapidly. The dissociation produces transitory low cortical thickness and vBMD in boys but not in girls. These structural features in part may account for the site and sex specificity of metaphyseal fractures during growth. ß

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Section: Introductionmentioning

confidence: 99%

Rapid growth produces transient cortical weakness: A risk factor for metaphyseal fractures during puberty

Wang

Iuliano-Burns

et al. 2010

Journal of Bone and Mineral Research

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112

100

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“…This diversity in structure is first expressed during growth, probably before puberty. (4)(5)(6)(7) The ranking or percentile location of a person's individual bone trait within the population distribution is established at some time during growth, and this location may make an important contribution to its ranking in old age when falls and fractures occur. a person's bone size, mass, density, or strength index is determined during intrauterine life and the trait then tracks during gestation, trait dimensions at birth should predict the trait location in adulthood.…”

Section: Introductionmentioning

confidence: 99%

Familial resemblance and diversity in bone mass and strength in the population are established during the first year of postnatal life

Wang

Alén

Lyytikäinen

et al. 2010

Journal of Bone and Mineral Research

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Familial resemblance and diversity in bone structure and strength in adulthood are determined in part during growth. Whether these characteristics are established during gestation or shortly after birth is not known. Total-body, lumbar spine, and femoral neck size and mass and indices of tibial bending strength and distal radial compressive strength were measured using bone densitometry and quantitative computed tomography in 236 girls at 18.5 years of age. Among them, 219, 141, and 105 girls had crown-heel length (CHL) and weight recorded at birth and at 6 and 12 months of age, and then height and weight were recorded at 3, 5, 10, 13, and 15 years of age in 181, 176, 127, 111, and 228 girls, respectively. Of these girls, 101 and 93 girls also had bone structure assessed at 11 and 13 years of age, respectively. Similar bone measurements were made once in 78 mother-father pairs. CHL and weight at birth did not correlate or did so weakly with bone traits in girls at 18 years of age. By contrast, CHL at 6 months correlated with the height, bone traits, and strength at puberty and at 18 years of age (r ¼ 0.24-0.56, p < .001) in girls and with their parents' height and bone traits (r ¼ 0.15-0.37, p < .05). When the girls' CHL at 6 months was stratified into quartiles, the absolute and relative differences in bone traits observed at puberty ($11.5 years) were maintained as these traits tracked during the ensuing 7 years. Similarly, weight at 6 months correlated with the girls' bone traits at puberty and 18 years of age (r ¼ 0.22-0.55, p < .05). During puberty and at 18 years of age, the girls' bone traits correlated with the corresponding traits in their parents (r ¼ 0.32-0.43, p < .01). It is concluded that familial resemblance in bone structural strength and the position of an individual's bone traits relative to others in adulthood are likely to be established during the first year of life. Thus susceptibility to bone fragility late in life has its antecedents established early in life. ß

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“…In non-dysplastic hips, the femoral head can be approximated as a sphere, the femoral neck being elliptical in cross section and roughly constant in size in the proximal part of the neck [6]. Samples of data points outside the head-neck area representing the patient-specific morphology of the femoral head and neck were acquired by means of spherical and elliptical least squares fitting, respectively.…”

Section: Morphological Analysis Of the Proximal Femurmentioning

confidence: 99%

A method for three-dimensional evaluation and computer aided treatment of femoroacetabular impingement

Audenaert

Vigneron

Pattyn

2011

Computer Aided Surgery

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Several theoretical models have shown that the range of motion of the hip joint is impaired in patients with femoroacetabular impingement, and that the acetabular cartilage is at risk of being damaged as a result of abnormal shear stresses, even during normal everyday activities. Computer aided technologies might add to the early diagnosis and adequate treatment of such lesions. This paper describes the technique, theories and algorithms we have developed for patient-specific detection, analysis and computer aided surgery of femoroacetabular impingement.Currently available models applicable to femoroacetabular impingement offer modeling based on collision analysis of a constrained hip joint. Such an approach implies that neither the femur nor the acetabulum can be analyzed completely separately for the presence of structural lesions responsible for the impingement problem. Moreover, a constrained model does not allow for comprehensive prediction of the possible locations and extent of secondary cartilage lesions (so-called contre-coup lesions) of the posterior acetabulum opposite the anterior impingement site. We report a new technique for the subject-specific morphological analysis of the proximal femur, acetabulum and hip joint. The technique offers a number of advantages compared to currently used techniques for the diagnosis and evaluation of hip impingement, and has direct orthopaedic applications as it allows computer aided planning and minimally invasive surgery for patients with femoroacetabular impingement.

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Femoral neck shape and the spatial distribution of its mineral mass varies with its size: Clinical and biomechanical implications

Cited by 75 publications

References 30 publications

Rapid growth produces transient cortical weakness: A risk factor for metaphyseal fractures during puberty

Rapid growth produces transient cortical weakness: A risk factor for metaphyseal fractures during puberty

Familial resemblance and diversity in bone mass and strength in the population are established during the first year of postnatal life

A method for three-dimensional evaluation and computer aided treatment of femoroacetabular impingement

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