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Distal skeletal tibia assessed by HR-pQCT is highly correlated with femoral and lumbar vertebra failure loads.
J Biomech. 2017 07 05; 59:43-49.JB

Abstract

Dual energy X-ray absorptiometry (DXA) is the standard for assessing fragility fracture risk using areal bone mineral density (aBMD), but only explains 60-70% of the variation in bone strength. High-resolution peripheral quantitative computed tomography (HR-pQCT) provides 3D-measures of bone microarchitecture and volumetric bone mineral density (vBMD), but only at the wrist and ankle. Finite element (FE) models can estimate bone strength with 86-95% precision. The purpose of this study is to determine how well vBMD and FE bone strength at the wrist and ankle relate to fracture strength at the hip and spine, and to compare these relationships with DXA measured directly at those axial sites. Cadaveric samples (radius, tibia, femur and L4 vertebra) were compared within the same body. The radius and tibia specimens were assessed using HR-pQCT to determine vBMD and FE failure load. aBMD from DXA was measured at the femur and L4 vertebra. The femur and L4 vertebra specimens were biomechanically tested to determine failure load. aBMD measures of the axial skeletal sites strongly correlated with the biomechanical strength for the L4 vertebra (r=0.77) and proximal femur (r=0.89). The radius correlated significantly with biomechanical strength of the L4 vertebra for vBMD (r=0.85) and FE-derived strength (r=0.72), but not with femur strength. vBMD at the tibia correlated significantly with femoral biomechanical strength (r=0.74) and FE-estimated strength (r=0.83), and vertebral biomechanical strength for vBMD (r=0.97) and FE-estimated strength (r=0.91). The higher correlations at the tibia compared to radius are likely due to the tibia's weight-bearing function.

Authors+Show Affiliations

Department of Radiology, Cumming School of Medicine, University of Calgary, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, Canada. Electronic address: akroker@ucalgary.ca.McCaig Institute for Bone and Joint Health, University of Calgary, Canada. Electronic address: rmplett@ucalgary.ca.McCaig Institute for Bone and Joint Health, University of Calgary, Canada. Electronic address: kn2205@cumc.columbia.edu.Department of Radiology, Cumming School of Medicine, University of Calgary, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, Canada. Electronic address: dave.mcerlain@gmail.com.Department of Radiology, Cumming School of Medicine, University of Calgary, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, Canada. Electronic address: clara.sandino@gmail.com.Department of Radiology, Cumming School of Medicine, University of Calgary, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, Canada. Electronic address: skboyd@ucalgary.ca.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28558915

Citation

Kroker, Andres, et al. "Distal Skeletal Tibia Assessed By HR-pQCT Is Highly Correlated With Femoral and Lumbar Vertebra Failure Loads." Journal of Biomechanics, vol. 59, 2017, pp. 43-49.
Kroker A, Plett R, Nishiyama KK, et al. Distal skeletal tibia assessed by HR-pQCT is highly correlated with femoral and lumbar vertebra failure loads. J Biomech. 2017;59:43-49.
Kroker, A., Plett, R., Nishiyama, K. K., McErlain, D. D., Sandino, C., & Boyd, S. K. (2017). Distal skeletal tibia assessed by HR-pQCT is highly correlated with femoral and lumbar vertebra failure loads. Journal of Biomechanics, 59, 43-49. https://doi.org/10.1016/j.jbiomech.2017.05.011
Kroker A, et al. Distal Skeletal Tibia Assessed By HR-pQCT Is Highly Correlated With Femoral and Lumbar Vertebra Failure Loads. J Biomech. 2017 07 5;59:43-49. PubMed PMID: 28558915.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Distal skeletal tibia assessed by HR-pQCT is highly correlated with femoral and lumbar vertebra failure loads. AU - Kroker,Andres, AU - Plett,Ryan, AU - Nishiyama,Kyle K, AU - McErlain,David D, AU - Sandino,Clara, AU - Boyd,Steven K, Y1 - 2017/05/18/ PY - 2016/09/26/received PY - 2017/05/11/revised PY - 2017/05/13/accepted PY - 2017/6/1/pubmed PY - 2017/12/13/medline PY - 2017/6/1/entrez KW - Bone microarchitecture KW - Bone strength KW - HR-pQCT KW - Multi-site KW - Osteoporosis SP - 43 EP - 49 JF - Journal of biomechanics JO - J Biomech VL - 59 N2 - Dual energy X-ray absorptiometry (DXA) is the standard for assessing fragility fracture risk using areal bone mineral density (aBMD), but only explains 60-70% of the variation in bone strength. High-resolution peripheral quantitative computed tomography (HR-pQCT) provides 3D-measures of bone microarchitecture and volumetric bone mineral density (vBMD), but only at the wrist and ankle. Finite element (FE) models can estimate bone strength with 86-95% precision. The purpose of this study is to determine how well vBMD and FE bone strength at the wrist and ankle relate to fracture strength at the hip and spine, and to compare these relationships with DXA measured directly at those axial sites. Cadaveric samples (radius, tibia, femur and L4 vertebra) were compared within the same body. The radius and tibia specimens were assessed using HR-pQCT to determine vBMD and FE failure load. aBMD from DXA was measured at the femur and L4 vertebra. The femur and L4 vertebra specimens were biomechanically tested to determine failure load. aBMD measures of the axial skeletal sites strongly correlated with the biomechanical strength for the L4 vertebra (r=0.77) and proximal femur (r=0.89). The radius correlated significantly with biomechanical strength of the L4 vertebra for vBMD (r=0.85) and FE-derived strength (r=0.72), but not with femur strength. vBMD at the tibia correlated significantly with femoral biomechanical strength (r=0.74) and FE-estimated strength (r=0.83), and vertebral biomechanical strength for vBMD (r=0.97) and FE-estimated strength (r=0.91). The higher correlations at the tibia compared to radius are likely due to the tibia's weight-bearing function. SN - 1873-2380 UR - https://www.unboundmedicine.com/medline/citation/28558915/Distal_skeletal_tibia_assessed_by_HR_pQCT_is_highly_correlated_with_femoral_and_lumbar_vertebra_failure_loads_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-9290(17)30263-4 DB - PRIME DP - Unbound Medicine ER -