Journal of Clinical Densitometry
Volume 11, Issue 3 , Pages 367-372 , July 2008

A Novel DXA-Based Hip Failure Index Captures Hip Fragility Independent of BMD

  • H. Sievänen

      Affiliations

    • Bone Research Group, UKK Institute, Tampere, Finland
    • Corresponding Author InformationAddress correspondence to: Dr. H. Sievänen, ScD, Bone Research Group, UKK Institute, P.O.B 30, FI-33501, Tampere, Finland.
  • ,
  • L.S. Weynand

      Affiliations

    • GE Healthcare, Madison, WI, USA
  • ,
  • W.K. Wacker

      Affiliations

    • GE Healthcare, Madison, WI, USA
  • ,
  • C. Simonelli

      Affiliations

    • HealthEast Clinics, Woodbury, MN, USA
  • ,
  • P.K. Burke

      Affiliations

    • Osteoporosis Diagnostic and Treatment Center, Richmond, VA, USA
  • ,
  • S. Ragi

      Affiliations

    • Centro de Diagnõstico e Pesquisa da Osteoporose do Espirito Santo, Vitoria, Brazil
  • ,
  • L. Del Rio

      Affiliations

    • CETIR Centre Medic, Barcelona, Spain

Received 19 September 2007 ,Revised 25 February 2008 ,Accepted 25 February 2008.

References 

  1. Parkkari J, Kannus P, Palvanen M, et al. Majority of hip fractures occur as a result of a fall and impact on the greater trochanter of the femur: a prospective controlled hip fracture study with 206 consecutive patients. Calcif Tissue Int. 1999;65:183–187
  2. Stone KL, Seeley DG, Lui LY, et al. BMD at multiple sites and risk of fracture of multiple types: long-term results from the Study of Osteoporotic Fractures. J Bone Miner Res. 2003;18:1947–1954
  3. Kanis JA, Johnell O, DeLaet C, et al. A meta-analysis of previous fracture and subsequent fracture risk. Bone. 2004;35:375–382
  4. Siris ES, Chen YT, Abbott TA, et al. Bone mineral density thresholds for pharmacological intervention to prevent fractures. Arch Intern Med. 2004;164:1108–1112
  5. Hernandez CJ, Keaveny TM. A biomechanical perspective on bone quality. Bone. 2006;39:1173–1181
  6. Sievanen H, Kannus P, Jarvinen TLN. Bone quality: an empty term. PLoS Med. 2007;4:e27
  7. Järvinen TLN, Sievanen H, Jokihaara J, Einhorn TA. Revival of bone strength: the bottom line. J Bone Miner Res. 2005;20:717–720
  8. Melton LJ, Beck TJ, Amin S, et al. Contributions of bone density and structure to fracture risk assessment in men and women. Osteoporos Int. 2005;16:460–467
  9. Ahlborg HG, Nguyen ND, Nguyen TV, et al. Contribution of hip strength indices to hip fracture risk in elderly men and women. J Bone Miner Res. 2005;20:1820–1827
  10. Szulc P, Duboeuf F, Schott AM, et al. Structural determinants of hip fracture in elderly women: re-analysis of the data from the EPIDOS study. Osteoporos Int. 2006;17(2):231–236
  11. Hayes WC, Myers ER, Robinovitch SN, et al. Etiology and prevention of age-related hip fractures. Bone. 1996;18:77S–86S
  12. Mayhew PM, Thomas CD, Clement JG, et al. Relation between age, femoral neck cortical stability, and hip fracture risk. Lancet. 2005;366:129–135
  13. Turner CH. The biomechanics of hip fracture. Lancet. 2005;366:98–99
  14. Peacock M, Turner CH, Liu G, et al. Better discrimination of hip fracture using bone density, geometry and architecture. Osteoporos Int. 1995;5:167–173
  15. Crabtree NJ, Kroger H, Martin A, et al. Improving risk assessment: hip geometry, bone mineral distribution and bone strength in hip fracture cases and controls. The EPOS study. European Prospective Osteoporosis Study. Osteoporos Int. 2002;13:48–54
  16. Pulkkinen P, Partanen J, Jalovaara P, Jamsa T. Combination of bone mineral density and upper femur geometry improves the prediction of hip fracture. Osteoporos Int. 2004;15:274–280
  17. Faulkner KG, Wacker WK, Barden HS, et al. Femur strength index predicts hip fracture independent of bone density and hip axis length. Osteoporos Int. 2006;17:593–599
  18. Yoshikawa T, Turner CH, Peacock M, et al. Geometric structure of the femoral neck measured using dual energy X-ray absorptiometry. J Bone Miner Res. 1994;9:1053–1064
  19. Gibson LJ, Ashby MF. Cellular Solids: Structure and Properties. 2nd ed.. Cambridge: Cambridge University Press; 1997;pp 345–360
  20. Carter DR, Hayes WC. Bone compressive strength: the influence of density and strain rate. Science. 1976;194:1174–1176
  21. Sievanen H, Jozsa L, Pap I, et al. Fragile external phenotype of modern human proximal femur in comparison with medieval bone. J Bone Miner Res. 2007;22:537–543
  22. Zebaze RM, Jones A, Welsh F, et al. Femoral neck shape and the spatial distribution of its mineral mass varies with its size: clinical and biomechanical implications. Bone. 2005;37:243–252
  23. Horikoshi T, Endo N, Uchiyama T, et al. Peripheral quantitative computed tomography of the femoral neck in 60 Japanese women. Calcif Tissue Int. 1999;65:447–453
  24. Sievanen H, Kannus P, Nieminen V, et al. Estimation of various mechanical characteristics of human bones using dual energy X-ray absorptiometry: methodology and precision. Bone. 1996;18:17S–27S
  25. Njeh CF, Hans D, Li J, et al. Comparison of six calcaneal quantitative ultrasound devices: precision and hip fracture discrimination. Osteoporos Int. 2000;11:1051–1062
  26. Sievanen H. A physical model for dual-energy X-ray absorptiometry-derived bone mineral density. Invest Radiol. 2000;35:325–330
  27. Michelotti J, Clark J. Femoral neck length and hip fracture risk. J Bone Miner Res. 1999;14:1714–1720
  28. Bolotin HH, Sievanen H. Inaccuracies inherent in dual-energy X-ray absorptiometry in in vivo bone mineral density can seriously mislead diagnostic/prognostic interpretations of patient specific fragility. J Bone Miner Res. 2001;16:799–805
  29. Rietbergen van B, Huiskes R, Eckstein F, Ruegsegger P. Trabecular bone tissue strains in the healthy and osteoporotic human femur. J Bone Miner Res. 2003;18:1781–1789
  30. Lang T, Augat P, Majumdar S, et al. Noninvasive assessment of bone density and structure using computed tomography and magnetic resonance. Bone. 1998;22:S149–S153
  31. Riggs BL, Melton LJ, Robb RA, et al. Population-based study of age and sex differences in bone volumetric density, size, geometry, and structure at different skeletal sites. J Bone Miner Res. 2004;19:1945–1954
  32. Krug R, Banerjee S, Han ET, et al. Feasibility of in vivo structural analysis of high-resolution magnetic resonance images of the proximal femur. Osteoporos Int. 2005;16:1307–1314
  33. Wehrli FW. Structural and functional assessment of trabecular and cortical bone by micro magnetic resonance imaging. J Magn Reson Imaging. 2007;25:390–409
  34. Bauer JS, Kohlmann S, Eckstein F, et al. Structural analysis of trabecular bone of the proximal femur using multislice computed tomography: a comparison with dual X-ray absorptiometry for predicting biomechanical strength in vitro. Calcif Tissue Int. 2006;78:78–89
  35. Prevrhal S, Engelke K, Kalender WA. Accuracy limits for the determination of cortical width and density: the influence of object size and CT imaging parameters. Phys Med Biol. 1999;44:751–764
  36. Gomberg BR, Wehrli FW, Vasilic B, et al. Reproducibility and error sources of micro-MRI-based trabecular bone structural parameters of distal radius and tibia. Bone. 2004;35:266–276
  37. Cheng X, Li J, Lu Y, et al. Proximal femoral density and geometry measurements by quantitative computed tomography: association with hip fracture. Bone. 2007;40:169–174

PII: S1094-6950(08)00032-2

doi: 10.1016/j.jocd.2008.02.005

Journal of Clinical Densitometry
Volume 11, Issue 3 , Pages 367-372 , July 2008