Subject-specific finite element models of long bones: An in vitro evaluation of the overall accuracy

Exercise loading history and femoral neck strength in a sideways fall: A three-dimensional finite element modeling study

“…While QCT would have provided high-resolution image data on femoral neck geometry and bone apparent density, MR imaging has been found to be adequately valid for the assessment of cortical geometry [25,62]. The pixel size in the previous QCTbased proximal femur studies [13,19,20] has been around 0.5 mm in contrast to the 0.9 mm pixel size in the present study. Obviously, a higher in-plane resolution would have provided a more accurate segmentation of the cortical bone.…”

“…Therefore, to comply with valid QCT-based proximal femur FE modeling studies, we adopted similar BCs and loading conditions [22,28]. In the present study, however, trabecular bone was modeled as a non-porous homogeneous structure in contrast to its actual non-uniform structure [63], which could cause < 10% error in the maximum stress reported in the literature [19]. However, according to Koivumäki et al, inclusion of the trabecular bone in the sideways falling FE models may not play a crucial role, and the proximal femoral strength can be…”

“…While the use of QCT-based FE models would have also allowed the estimation of inhomogeneous elastic properties using the voxel-based Hounsfield unit data (density) [11][12][13][18][19][20][21][22], the assumption of homogeneous material properties is acceptable.…”

“…However, the influence of this exercise-induced structural benefit on femoral neck strength in the sideways fall was not examined. Several FE modeling studies have been conducted to obtain a better understanding of the hip fracture mechanism [3,6,9,[11][12][13][18][19][20][21][22]. To the best of our knowledge, however, no FE modeling study has so far been conducted to investigate the influence of specific exercise loading…”

A quasi-brittle continuum damage finite element model of the human proximal femur based on element deletion

“…Empirical relations between the orthotropic constants and bone density have been suggested by several authors [29][30][31][32][33][34]. Nevertheless, the determination of material trajectories related to the trabecular orientations from clinical quantitative computed tomography (QCT) scans remains an open question [64,71,74,86].…”