Research Article of American Journal of Orthopedic Research and Reviews
Computational Analysis of Femoral Strength and Fracture Location of Normal, Osteoarthritis and Avascular Necrosis Femurs using CT-Image based Finite Element Method
Zaw Linn Htun1, 3, Mitsugu Todo1, 2, Manabu Tsukamoto4, Takuaki Yamamoto5 , Masaaki Mawatari6, Yasuharu Nakashima7
1Interdisciplinary Graduate School of Engineering Sciences, Kyushu University 6-1 Kasuga-koen, Kasuga 816-8580, Japan; 2. Research Institute for Applied Mechanics, Kyushu University 6-1 Kasuga-koen, Kasuga 816-8580, Japan; 3. Department of Physics, University of Yangon, 11041 Kamayut, Yangon, Myanmar; 4. Department of Orthopaedic Surgery, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan; 5. Department of Orthopedic Surgery, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180; 6. Department of Orthopedic Surgery, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan; 7. Department of Orthopaedic Surgery, Kyushu University 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8580, Japan
Recent years, the risk of hip fractures in elderly people has exponentially increased due to a progressive loss of bone mass and bone structure deterioration due to osteoporosis and increased incidental falls. It is, therefore, expected that the prediction of femoral strength and fracture location of specific patient will be clinically very useful. It is also considered that some typical femoral diseases such as osteoarthritis (OA) and avascular necrosis (AVN) could affect the strength and fracture behaviour of the femurs. In this study, 130 computational femoral models were constructed using CT images of 73 patients. Then, CT image based finite element method (CT-FEM) combined with a damage mechanics analysis was applied to predict the fracture load as the femoral strength and the fracture location of the femoral models. The computational results exhibited that the fracture load tended to increase with increase of the volumetric bone mineral density (vBMD) estimated in the femoral head and neck region in all the three types of models, although AVN models showed much wider scatter in the data than the other two types. The bone fracture behaviour was expressed as expressed as the distribution of failure elements in the head and neck region. The bone fracture mainly took place in the neck region for all types of femoral model. In addition, a combination of the head and neck fracture was also observed in all the models. A combination of neck and intertrochanteric fracture was also observed in the normal and AVN groups.
Keywords: Finite element analysis, Femoral strength, Fracture location, Osteoarthritis, Avascular necrosis, Bone mineral density
How to cite this article:
Zaw Linn Htun, Mitsugu Todo, Manabu Tsukamoto, Takuaki Yamamoto, Masaaki Mawatari, Yasuharu Nakashima.Computational Analysis of Femoral Strength and Fracture Location of Normal, Osteoarthritis and Avascular Necrosis Femurs using CT-Image based Finite Element Method .American Journal of Orthopedic Research and Reviews, 2022, 5:32. DOI: 10.28933/ajorr-2022-04-1705
References:
1. Cummings SR, Rubin SM, Black D. The future of hip fractures in the United States. Numbers, costs, and potential effects of postmenopausal estrogen. Clinical Orthopaedics and Related Research 1990;(252):163–6.
2. Lang TF, Keyak JH, Heitz MW, Augat P, Lu Y, Mathur A, Genant HK. Volumetric quantitative computed tomography of the proximal femur: Precision and relation to bone strength. Bone 1997; 21(1): 101–8.
3. Keyak JH, Rossi SA, Jones KA, Skinner HB. Prediction of femoral fracture load using automated finite element modeling. Journal of Biomechanics 1998;31(2):125–33.
4. Ota T, Yamamoto I, Morita R. Fracture simulation of the femoral bone using the finiteelement method: How a fracture initiates and proceeds. Journal of Bone and Mineral Metabolism 1999;17(2):108–12.
5. Cody DD, Gross GJ, J. Hou F, Spencer HJ, Goldstein S a., P. Fyhrie D. Femoral strength is better predicted by finite element models than QCT and DXA. Journal of Biomechanics 1999;32(10):1013–20.
6. Keyak JH, Rossi SA, Jones KA, Les CM, Skinner HB. Prediction of fracture location in the proximal femur using finite element models. Medical Engineering and Physics 2001; 23(9):657–64.
7. Bessho M, Ohnishi I, Matsuyama J, Matsumoto T, Imai K, Nakamura K. Prediction of strength and strain of the proximal femur by a CT-based finite element method. Journal of Biomechanics 2007; 40(8): 1745–53.
8. Gustafsson A, Tognini M, Bengtsson F, Gasser TC, Isaksson H, Grassi L. Subjectspecific FE models of the human femur predict fracture path and bone strength under single-leg-stance loading. Journal of Mechanical Behavior of Biomedical Materials 2021; 113: 104118.
9. Abdullah AH, Todo M, Nakashima Y. Prediction of damage formation in hip arthroplasties by finite element analysis using computed tomography images. Medical Engineering and Physics 2017; 44: 8-15.
10. Cristofolini L, Schileo E, Juszczyk M, Taddei F, Martelli S, Viceconti M. Mechanical testing of bones: The positive synergy of finite-element models and in vitro experiments. Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences 2010; 368(1920): 2725–63.
11. Ulrich D, Van Rietbergen B, Weinans H, Rüegsegger P. Finite element analysis of trabecular bone structure: A comparison of image-based meshing techniques. Journal of Biomechanics 1998; 31(12): 1187–92.
12. Dalstra M, Huiskes R, van Erning L. Development and validation of a three-dimensional finite element model of the pelvic bone. Journal of Biomechanical Engineering 1995; 117(3): 272–8.
13. Keyak JH, Skinner HB, Fleming JA. Effect of force direction on femoral fracture load for two types of loading conditions. Journal of Orthopaedic Research 2001; 19(4): 539–44.
14. Sato T, Yonezawa I, Mitsugu T, Takano H, Kaneko K. Biomechanical effects of implant materials on posterior lumbar interbody fusion: comparison of polyetheretherketone and titanium spacers using finite element analysis and considering bone density. Journal of Biomedical Science and Engineering 2018; 11(4): 45-59.
15. Masatoshi O, Kobayashi N, Inaba Y, Choe H, Ike H, Kubota S, Saito T. Mechanical Strength of the Proximal Femur After Arthroscopic Osteochondroplasty for Femoroacetabular Impingement: Finite Element Analysis and 3-Dimensional Image Analysis. Arthroscopy 2018; 34(8): 2377-2386.
16. Murphey MD, Roberts CC, Bencardino JT, Appel M, Arnold E, Chang EY, et al. ACR Appropriateness Criteria Osteonecrosis of the Hip. Journal of the American College of Radiology 2016; 13(2): 147–55.
Terms of Use/Privacy Policy/ Disclaimer/ Other Policies:
You agree that by using our site/services, you have read, understood, and agreed to be bound by all of our terms of use/privacy policy/ disclaimer/ other policies (click here for details).
CC BY 4.0
This work and its PDF file(s) are licensed under a Creative Commons Attribution 4.0 International License.