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Prediction of bone strength at the distal tibia by HR-pQCT and DXA.
Bone. 2012 Jan; 50(1):296-300.BONE

Abstract

BACKGROUND

Areal bone mineral density (aBMD) at the distal tibia, measured at the epiphysis (T-EPI) and diaphysis (T-DIA), is predictive for fracture risk. Structural bone parameters evaluated at the distal tibia by high resolution peripheral quantitative computed tomography (HR-pQCT) displayed differences between healthy and fracture patients. With its simple geometry, T-DIA may allow investigating the correlation between bone structural parameter and bone strength.

METHODS

Anatomical tibiae were examined ex vivo by DXA (aBMD) and HR-pQCT (volumetric BMD (vBMD) and bone microstructural parameters). Cortical thickness (CTh) and polar moment of inertia (pMOI) were derived from DXA measurements. Finally, an index combining material (BMD) and mechanical property (polar moment of inertia, pMOI) was defined and analyzed for correlation with torque at failure and stiffness values obtained by biomechanical testing.

RESULTS

Areal BMD predicted the vBMD at T-EPI and T-DIA. A high correlation was found between aBMD and microstructural parameters at T-EPIas well as between aBMD and CTh at T-DIA. Finally, at T-DIA both indexes combining BMD and pMOI were strongly and comparably correlated with torque at failure and bone stiffness.

CONCLUSION

Ex vivo, at the distal tibial diaphysis, a novel index combining BMD and pMOI, which can be calculated directly from a single DXA measurement, predicted bone strength and stiffness better than either parameter alone and with an order of magnitude comparable to that of HR-pQCT. Whether this index is suitable for better prediction of fracture risk in vivo deserves further investigation.

Authors+Show Affiliations

AO Research Institute Davos, Switzerland. albrecht.popp@aofoundation.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22088678

Citation

Popp, Albrecht W., et al. "Prediction of Bone Strength at the Distal Tibia By HR-pQCT and DXA." Bone, vol. 50, no. 1, 2012, pp. 296-300.
Popp AW, Windolf M, Senn C, et al. Prediction of bone strength at the distal tibia by HR-pQCT and DXA. Bone. 2012;50(1):296-300.
Popp, A. W., Windolf, M., Senn, C., Tami, A., Richards, R. G., Brianza, S., & Schiuma, D. (2012). Prediction of bone strength at the distal tibia by HR-pQCT and DXA. Bone, 50(1), 296-300. https://doi.org/10.1016/j.bone.2011.10.033
Popp AW, et al. Prediction of Bone Strength at the Distal Tibia By HR-pQCT and DXA. Bone. 2012;50(1):296-300. PubMed PMID: 22088678.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prediction of bone strength at the distal tibia by HR-pQCT and DXA. AU - Popp,Albrecht W, AU - Windolf,Markus, AU - Senn,Christoph, AU - Tami,Andrea, AU - Richards,R Geoff, AU - Brianza,Stefano, AU - Schiuma,Damiano, Y1 - 2011/11/09/ PY - 2011/07/25/received PY - 2011/10/13/revised PY - 2011/10/29/accepted PY - 2011/11/18/entrez PY - 2011/11/18/pubmed PY - 2012/4/13/medline SP - 296 EP - 300 JF - Bone JO - Bone VL - 50 IS - 1 N2 - BACKGROUND: Areal bone mineral density (aBMD) at the distal tibia, measured at the epiphysis (T-EPI) and diaphysis (T-DIA), is predictive for fracture risk. Structural bone parameters evaluated at the distal tibia by high resolution peripheral quantitative computed tomography (HR-pQCT) displayed differences between healthy and fracture patients. With its simple geometry, T-DIA may allow investigating the correlation between bone structural parameter and bone strength. METHODS: Anatomical tibiae were examined ex vivo by DXA (aBMD) and HR-pQCT (volumetric BMD (vBMD) and bone microstructural parameters). Cortical thickness (CTh) and polar moment of inertia (pMOI) were derived from DXA measurements. Finally, an index combining material (BMD) and mechanical property (polar moment of inertia, pMOI) was defined and analyzed for correlation with torque at failure and stiffness values obtained by biomechanical testing. RESULTS: Areal BMD predicted the vBMD at T-EPI and T-DIA. A high correlation was found between aBMD and microstructural parameters at T-EPIas well as between aBMD and CTh at T-DIA. Finally, at T-DIA both indexes combining BMD and pMOI were strongly and comparably correlated with torque at failure and bone stiffness. CONCLUSION: Ex vivo, at the distal tibial diaphysis, a novel index combining BMD and pMOI, which can be calculated directly from a single DXA measurement, predicted bone strength and stiffness better than either parameter alone and with an order of magnitude comparable to that of HR-pQCT. Whether this index is suitable for better prediction of fracture risk in vivo deserves further investigation. SN - 1873-2763 UR - https://www.unboundmedicine.com/medline/citation/22088678/Prediction_of_bone_strength_at_the_distal_tibia_by_HR_pQCT_and_DXA_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S8756-3282(11)01337-8 DB - PRIME DP - Unbound Medicine ER -