Dataset Information

Femoral neck strain prediction during level walking using a combined musculoskeletal and finite element model approach.

ABSTRACT: Recently, coupled musculoskeletal-finite element modelling approaches have emerged as a way to investigate femoral neck loading during various daily activities. Combining personalised gait data with finite element models will not only allow us to study changes in motion/movement, but also their effects on critical internal structures, such as the femur. However, previous studies have been hampered by the small sample size and the lack of fully personalised data in order to construct the coupled model. Therefore, the aim of this study was to build a pipeline for a fully personalised multiscale (body-organ level) model to investigate the strain levels at the femoral neck during a normal gait cycle. Five postmenopausal women were included in this study. The CT and MRI scans of the lower limb, and gait data were collected for all participants. Muscle forces derived from the body level musculoskeletal models were used as boundary constraints on the finite element femur models. Principal strains were estimated at the femoral neck region during a full gait cycle. Considerable variation was found in the predicted peak strain among individuals with mean peak first principal strain of 0.24% ± 0.11% and mean third principal strain of -0.29% ± 0.24%. For four individuals, two overall peaks of the maximum strains were found to occur when both feet were in contact with the floor, while one individual had one peak at the toe-off phase. Both the joint contact forces and the muscular forces were found to substantially influence the loading at the femoral neck. A higher correlation was found between the predicted peak strains and the gluteus medius (R2 ranged between 0.95 and 0.99) than the hip joint contact forces (R2 ranged between 0.63 and 0.96). Therefore, the current findings suggest that personal variations are substantial, and hence it is important to consider multiple subjects before deriving general conclusions for a target population.

SUBMITTER: Altai Z

PROVIDER: S-EPMC7850486 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Femoral neck strain prediction during level walking using a combined musculoskeletal and finite element model approach.

Altai Zainab Z Montefiori Erica E van Veen Bart B A Paggiosi Margaret M McCloskey Eugene V EV Viceconti Marco M Mazzà Claudia C Li Xinshan X

PloS one 20210201 2

Recently, coupled musculoskeletal-finite element modelling approaches have emerged as a way to investigate femoral neck loading during various daily activities. Combining personalised gait data with finite element models will not only allow us to study changes in motion/movement, but also their effects on critical internal structures, such as the femur. However, previous studies have been hampered by the small sample size and the lack of fully personalised data in order to construct the coupled ...[more]

PMID: 33524024

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Project description:A bone fractures only when loaded beyond its strength. The purpose of this study was to determine the association of femoral strength, as estimated by finite element (FE) analysis of dual-energy X-ray absorptiometry (DXA) scans, with incident hip fracture in comparison to hip bone mineral density (BMD), Fracture Risk Assessment Tool (FRAX), and hip structure analysis (HSA) variables. This prospective case-cohort study included a random sample of 1941 women and 668 incident hip fracture cases (295 in the random sample) during a mean?±?SD follow-up of 12.8?±?5.7 years from the Study of Osteoporotic Fractures (n?=?7860 community-dwelling women ?67 years of age). We analyzed the baseline DXA scans (Hologic 1000) of the hip using a validated plane-stress, linear-elastic finite element (FE) model of the proximal femur and estimated the femoral strength during a simulated sideways fall. Cox regression accounting for the case-cohort design assessed the association of estimated femoral strength with hip fracture. The age-body mass index (BMI)-adjusted hazard ratio (HR) per SD decrease for estimated strength (2.21; 95% CI, 1.95-2.50) was greater than that for total hip (TH) BMD (1.86; 95% CI, 1.67-2.08; p?<?0.05), FN BMD (2.04; 95% CI, 1.79-2.32; p?>?0.05), FRAX scores (range, 1.32-1.68; p?<?0.0005), and many HSA variables (range, 1.13-2.43; p?<?0.005), and the association was still significant (p?<?0.05) after further adjustment for hip BMD or FRAX scores. The association of estimated strength with incident hip fracture was strong (Harrell's?C index 0.770), significantly better than TH BMD (0.759; p?<?0.05) and FRAX scores (0.711-0.743; p?<?0.0001), but not FN BMD (0.762; p?>?0.05). Similar findings were obtained for intracapsular and extracapsular fractures. In conclusion, the estimated femoral strength from FE analysis of DXA scans is an independent predictor and performs at least as well as FN BMD in predicting incident hip fracture in postmenopausal women.

Dataset Information

Femoral neck strain prediction during level walking using a combined musculoskeletal and finite element model approach.

Publications

Femoral neck strain prediction during level walking using a combined musculoskeletal and finite element model approach.

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