scholarly journals Morphological characteristics of the developing proximal femur: A biomechanical perspective

2012 ◽  
Vol 140 (11-12) ◽  
pp. 738-745 ◽  
Author(s):  
Marija Djuric ◽  
Petar Milovanovic ◽  
Danijela Djonic ◽  
Arsa Minic ◽  
Michael Hahn
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Morphological Characteristics ◽  
Strong Relationship ◽  
Bone Adaptation ◽  
Shear Stresses ◽  
Mineral Density ◽  
Continuous Increase ◽  
Trabecular Pattern ◽  
Internal Morphology

Introduction. In contrast to a plethora of studies on the proximal femur in adults, its external and internal morphology in growing children has not been sufficiently analyzed. Objective. We analyzed changes in external and internal morphology of the proximal femur during growth and development to interpret the links between them and concepts of the human femoral biomechanics. Methods. We assessed external geometry, internal trabecular and cortical arrangement, and bone mineral density (BMD) of the proximal femur in 29 children (age at death from 1 month to 14 years) from archaeological context by using microscopic and radiographic methods. Results. The results showed that both the femoral neck width and length increased with age, with the femoral neck becoming more elongated, while the collo-diaphyseal angle decreased. A strong relationship between age and adjusted areal BMD was found, showing continuous increase during childhood. Parallel trabecular pattern at birth changed to mature three distinct trabecular groups (longitudinal ? principal compressive, transversal ? tensile and randomly scattered) starting from the age of 8 months. In older children the superior and inferior aspects of the femoral neck differently changed with growth, with medial neck having thicker cortex and trabeculae. Conclusion. In the light of bone adaptation principle, the observed changes in external and internal morphology are governed by mechanical forces acting on the developing femur. Our findings on the development of trabecular pattern and cortical distribution are compatible with recent views on the femoral biomechanics which point out the predominance of compressive stresses in the femoral neck, adaptation to shear stresses, multiaxial loading perspective, prevalence of muscle effects over body weight, and existence of adaptational eccentricity.

scholarly journals The Femoral Neck Mechanoresponse to Hip Extensors Exercise: A Case Study

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Saulo Martelli ◽  
Hossein Mokhtarzadeh ◽  
Peter Pivonka ◽  
Peter R. Ebeling
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Bone Adaptation ◽  
Areal Bone Mineral Density ◽  
Mineral Density ◽  
Strain Pattern ◽  
Age Related ◽  
Extensor Muscles ◽  
Negative Effect ◽  
Trochanteric Region

Physical activity is recommended to prevent age-related bone loss. However, the proximal femur mechanoresponse is variable, possibly because of a muscle-dependant mechanoresponse. We compared the proximal femur response with the femoral strain pattern generated by the hip extensor muscles. A healthy participant underwent a six-month unilateral training of the hip extensor muscles using a resistance weight regularly adjusted to the 80% of the one-repetition maximum weight. DXA-based measurements of the areal Bone Mineral Density (aBMD) in the exercise leg were adjusted for changes in the control leg. The biomechanical stimulus for bone adaptation (BS) was calculated using published models of the musculoskeletal system and the average hip extension moment in elderly participants. Volumetric (ΔvBMD) and areal (ΔaBMD) BMD changes were calculated. The measured and calculated BMD changes consistently showed a positive and negative effect of exercise in the femoral neck (ΔaBMD = +0.7%; ΔvBMD = +0.8%) and the trochanter region (ΔaBMD = −4.1%; ΔvBMD = −0.5%), respectively. The 17% of the femoral neck exceeded the 75th percentile of the spatially heterogeneous BS distribution. Hip extensor exercises may be beneficial in the proximal femoral neck but not in the trochanteric region. DXA-based measurements may not capture significant aBMD local changes.

scholarly journals Treatment of Proximal Femur Fractures on the Background of Osteoporosis

2004 ◽  
Vol 11 (1) ◽  
pp. 27-31 ◽  
Author(s):  
A F Lazarev ◽  
E I Solod ◽  
A O Ragozin ◽  
M G Kakabadze ◽  
A F Lazarev ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Femoral Neck Fractures ◽  
Mineral Density ◽  
Stable Fixation ◽  
Fracture Characteristics ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Choice Of Treatment ◽  
Density Evaluation

Analysis of treatment of 526 patients with proximal femur fractures (362 patients with femoral neck fractures and 164 patients with trochanteric zone fractures) was performed. Patients' age ranged from 34 to 92 (mean 67). Algorithm of differentiated choice of operative tactics depending on fracture characteristics and injury term was presented. Low invasive osteosynthesis of femoral neck with bundle of stressed V-shaped pins was suggested. Theoretical and practical ground of that technique was given. Stress within fixative-bone system created after osteosynthesis by V-shaped pins, provided stable fixation even in marked osteoporosis. The importance of bone mineral density evaluation for the choice of treatment tactics as well as the necessity of medicamental correction of the disturbed bone remodeling after surgical treatment was noted.

scholarly journals Mechanical torque measurement in the proximal femur correlates to failure load and bone mineral density ex vivo

2013 ◽  
Vol 5 (2) ◽  
pp. 16 ◽  
Author(s):  
Stefan Grote ◽  
Tatjana Noeldeke ◽  
Michael Blauth ◽  
Wolf Mutschler ◽  
Dominik Bürklein
Keyword(s):  
Bone Mineral Density ◽  
Femoral Neck ◽  
Bone Quality ◽  
Bone Mineral ◽  
Proximal Femur ◽  
Failure Load ◽  
Peak Torque ◽  
Mineral Density ◽  
Local Bone ◽  
Load To Failure

Knowledge of local bone quality is essential for surgeons to determine operation techniques. A device for intraoperative measurement of local bone quality has been developed by the AO-Research Foundation (DensiProbe®). We used this device to experimentally measure peak breakaway torque of trabecular bone in the proximal femur and correlated this with local bone mineral density (BMD) and failure load. Bone mineral density of 160 cadaver femurs was measured by <em>ex situ </em>dual-energy X-ray absorptiometry. The failure load of all femurs was analyzed by side-impact analysis. Femur fractures were fixed and mechanical peak torque was measured with the DensiProbe® device. Correlation was calculated whereas correlation coefficient and significance was calculated by Fisher’s Z-transformation. Moreover, linear regression analysis was carried out. The unpaired Student’s t-test was used to assess the significance of differences. The Ward triangle region had the lowest BMD with 0.511 g/cm2 (±0.17 g/cm2), followed by the upper neck region with 0.546 g/cm2 (±0.16 g/cm2), trochanteric region with 0.685 g/cm2 (±0.19 g/cm2) and the femoral neck with 0.813 g/cm2 (±0.2 g/cm2). Peak torque of DensiProbe® in the femoral head was 3.48 Nm (±2.34 Nm). Load to failure was 4050.2 N (±1586.7 N). The highest correlation of peak torque measured by Densi Probe® and load to failure was found in the femoral neck (r=0.64, P&lt;0.001). The overall correlation of mechanical peak torque with T-score was r=0.60 (P&lt;0.001). A correlation was found between mechanical peak torque, load to failure of bone and BMD <em>in vitro</em>. Trabecular strength of bone and bone mineral density are different aspects of bone strength, but a correlation was found between them. Mechanical peak torque as measured may contribute additional information about bone strength, especially in the perioperative testing.

scholarly journals Bone Mineral Density and Jumping Height in Pre-Menarcheal and Post-Menarcheal Physically Active Girls

2018 ◽  
Vol 3 (82) ◽  
Author(s):  
Rita Gruodytė ◽  
Toivo Jürimäe
Keyword(s):  
Bone Mineral Density ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Bone Health ◽  
Bone Growth ◽  
Weight Bearing ◽  
Bone Adaptation ◽  
Mineral Density ◽  
Physically Active ◽  
Vertical Jumps

Research background and hypothesis. Jumping ability correlates well with different bone values. The skeletal benefits of high-impact weight-bearing exercise have been shown to be greater when training is started prior to menarche. We hypothesized that significant differences would be apparent in the relationships between bone values and jumping height in favor of the girls’ prior menarche compared to post-menarcheal group. Research aim. The aim of the study was to investigate the relationships between jumping height and bone mineral density (BMD) in pre-menarcheal and post-menarcheal physically active girls. Research  methods.  In  total,  113  adolescent  girls  from  different  competitive  extramural  athletic  programs participated in this study. Femoral neck and lumbar spine BMD were measured. The heights of vertical jumps (i. e. countermovement jump (CMJ) and rebound jumps for 15 (RJ  15 s) and 30 (RJ  30 s) seconds) were obtained.Research results. After adjusting for major confounders (i. e. age, height, and body mass), the height of rebound jumps correlated only with femoral neck BMD and only in pre-menarcheal group (r = 0.37–0.46; p < 0.05). No correlations were found between BMD variables and jumping height in post-menarcheal girls. The height of CMJ did not correlate with measured BMD variables in the studied groups.Discussion and conclusions. Early puberty is an opportune period to increase bone adaptation to mechanical loading due to the velocity of bone growth and endocrine changes at this time. We suggest that powerful repetitive vertical jumping may be more beneficial to bone health compared to single jumping activities in physically active girls prior to menarche rather than after it.Keywords: bone health, vertical jumps, puberty.

scholarly journals Four-Year Teriparatide Followed by Denosumab vs. Continuous Denosumab in Glucocorticoid-Induced Osteoporosis Patients With Prior Bisphosphonate Treatment

2021 ◽  
Vol 12 ◽  
Author(s):  
Yasuaki Hirooka ◽  
Yuji Nozaki ◽  
Saki Okuda ◽  
Masafumi Sugiyama ◽  
Koji Kinoshita ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bisphosphonate Treatment ◽  
Mineral Density ◽  
Continuous Increase ◽  
Teriparatide Treatment ◽  
Hip Bmd ◽  
To Receive ◽  
Switch Group

ObjectivesIn our previous 24-month study, we observed that teriparatide had some advantages over denosumab for bone mineral density (BMD) in glucocorticoid-induced osteoporosis (GIO) patients with prior bisphosphonate treatment. We conducted this extension study to investigate whether the advantage of teriparatide obtained in the first 2 years would be maintained after the switch to denosumab.Materials and MethodsWe switched patients who had completed 24-month daily teriparatide treatment to denosumab (switch group, n=18) and compared their BMD every 6 months up to 48 months with the group who continued to receive denosumab (denosumab group, n=16).ResultsAt 48 months, the lumbar spine BMD was significantly increased from baseline in both groups (denosumab: 10.4 ± 8.7%, p&lt;0.001; switch: 14.2 ± 6.8%, p&lt;0.001). However, a significant increase in femoral neck BMD from baseline occurred only in the switch group (11.2 ± 14.6%, p&lt;0.05); denosumab (4.1 ± 10.8%). The total hip BMD increased significantly from baseline in both groups (denosumab: 4.60 ± 7.4%, p&lt;0.05; switch: 7.2 ± 6.9%, p&lt;0.01). Femoral neck BMD was significantly increased in the switch versus the denosumab group (p&lt;0.05).ConclusionIn GIO patients with prior bisphosphonate treatment, the advantage of teriparatide may be maintained after the treatment period. A continuous increase in BMD can be expected with teriparatide followed by denosumab.

scholarly journals The correlation between volumetric bone mineral density and morphological parameters of the proximal femur and clinical outcomes in ankylosing spondylitis patients with hip involvement

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Xinfeng Wu ◽  
Liang Zhang ◽  
Tao Bian ◽  
Siliang Man ◽  
Hongchao Li ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Ankylosing Spondylitis ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Proximal Femur ◽  
Volumetric Bone Mineral Density ◽  
Morphological Parameters ◽  
Mineral Density ◽  
T Score ◽  
Group A

Abstract Background To measure volumetric bone mineral density (vBMD) with quantitative computed tomography (QCT) in the proximal femur of ankylosing spondylitis (AS) patients with hip involvement and analyze their correlations with radiographic and clinical parameters. Methods Sixty-five AS inpatients were enrolled in this study. The bone mineral density was measured by QCT and dual-energy x-ray absorptiometry (DXA), respectively. The morphological parameters of the proximal femur were measured on digital anteroposterior (AP) radiographs of the pelvis. The correlations between them were analyzed by SPSS software. Results The average trabecular vBMD measured at the femoral neck was 136.38 ± 25.58 mg/cm3. According to the BASRI-Hip score, group A consisted of 39 hips (0–2 score) and group B consisted of 26 hips (3–4 score). There were significant differences regarding trabecular CTXA equivalent T-score between group A and B at the femoral neck (p = 0.004); intertrochanteric region (p < 0.001) and greater trochanter (p = 0.001). The trabecular CTXA equivalent T-score at femoral neck had a negative correlation with disease duration (r = − 0.311, p = 0.012) and with CBR (r = − 0.319, p = 0.010). Conclusions The low trabecular bone density at the site of the hip was associated with the duration of disease progression and degree of hip involvement. Meanwhile, it had a correlation with hip function status although we failed to confirm a significant relationship between hip vBMD and disease activity.

Optical Processing of Radiographic Trabecular Pattern Versus Bone Mineral Density of Proximal Femur as Measures of Bone Strength

2001 ◽  
Vol 4 (2) ◽  
pp. 121-129 ◽  
Author(s):  
Isaac S. Leichter ◽  
Ariel Simkin ◽  
Victor Neeman ◽  
Christian Jabschinsky ◽  
David Schoenfeld ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Strength ◽  
Bone Mineral ◽  
Proximal Femur ◽  
Optical Processing ◽  
Mineral Density ◽  
Trabecular Pattern ◽  
Pattern Versus
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