Ageing effects on 3-dimensional femoral neck cross-sectional asymmetry: Implications for age-related bone fragility in falling

Benjamin Khoo, Keenan Brown, Joshua Lewis, Egon Perilli, Richard Prince

Research output: Contribution to journalArticle

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Abstract

This paper explores the effects of aging on femoral neck (FN) anatomy in a study of women aged 20–90 years in relation to implications for FN fracture propensity in buckling. Five hundred and four participants were scanned by Quantitative Computed Tomography and analyzed using Quantitative Computed Tomography Pro BIT (Mindways). FN cross-section was split through geometric center into superior and inferior sectors. Bone mass, structural measurements, and bone mineral density were analyzed. Buckling ratio was calculated as ratio of buckling radius to cortical thickness. Between 2nd decade and 8th decade, age-related integral bone mass reduction in superior sector was substantially larger than in inferior sector (33% compared to 21%), especially in cortical bone superiorly compared to inferiorly (53% vs 21%; p < 0.001), principally due to reduction in cortical thickness, averaged cortical thickness (56%) with little difference in density. Superior and inferior sector trabecular bone mineral density reduction was similar at 41% and 43% respectively. Differential cortical bone loss in superior sector resulted in a 59% inferior displacement (δ) of center-of-mass from geometric center. Differences in δ and averaged cortical thickness with age accounted for a 151% increase in mean superior buckling ratio from 9 to 23. Analysis confirms significant progressive age-related superior cortical bone loss as the major age effect on FN structure with relative preservation of inferior cortex probably related to maintenance of inferior sector by regular loading as a result of standing and walking. Computation of buckling ratio may allow prediction of fracture propensity in a sideways fall. © 2018 The International Society for Clinical Densitometry
Original languageEnglish
Pages (from-to)153-161
Number of pages9
JournalJournal of Clinical Densitometry
Volume22
Issue number2
DOIs
Publication statusPublished - 1 Apr 2019

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Accidental Falls
Femur Neck
Bone and Bones
Bone Density
Tomography
Femoral Neck Fractures
Walking
Anatomy
Maintenance
Cortical Bone

Cite this

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title = "Ageing effects on 3-dimensional femoral neck cross-sectional asymmetry: Implications for age-related bone fragility in falling",
abstract = "This paper explores the effects of aging on femoral neck (FN) anatomy in a study of women aged 20–90 years in relation to implications for FN fracture propensity in buckling. Five hundred and four participants were scanned by Quantitative Computed Tomography and analyzed using Quantitative Computed Tomography Pro BIT (Mindways). FN cross-section was split through geometric center into superior and inferior sectors. Bone mass, structural measurements, and bone mineral density were analyzed. Buckling ratio was calculated as ratio of buckling radius to cortical thickness. Between 2nd decade and 8th decade, age-related integral bone mass reduction in superior sector was substantially larger than in inferior sector (33{\%} compared to 21{\%}), especially in cortical bone superiorly compared to inferiorly (53{\%} vs 21{\%}; p < 0.001), principally due to reduction in cortical thickness, averaged cortical thickness (56{\%}) with little difference in density. Superior and inferior sector trabecular bone mineral density reduction was similar at 41{\%} and 43{\%} respectively. Differential cortical bone loss in superior sector resulted in a 59{\%} inferior displacement (δ) of center-of-mass from geometric center. Differences in δ and averaged cortical thickness with age accounted for a 151{\%} increase in mean superior buckling ratio from 9 to 23. Analysis confirms significant progressive age-related superior cortical bone loss as the major age effect on FN structure with relative preservation of inferior cortex probably related to maintenance of inferior sector by regular loading as a result of standing and walking. Computation of buckling ratio may allow prediction of fracture propensity in a sideways fall. {\circledC} 2018 The International Society for Clinical Densitometry",
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Ageing effects on 3-dimensional femoral neck cross-sectional asymmetry : Implications for age-related bone fragility in falling. / Khoo, Benjamin; Brown, Keenan; Lewis, Joshua; Perilli, Egon; Prince, Richard.

In: Journal of Clinical Densitometry, Vol. 22, No. 2, 01.04.2019, p. 153-161.

Research output: Contribution to journalArticle

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