Are BMD and CT-FEA effective surrogate markers of femoral bone strength?

January 22, 2020

A new International Osteoporosis Foundation (IOF) position paper reviews experimental and clinical evidence showing that hip bone strength estimated by bone mineral density (BMD) and/or finite element analysis (FEA) reflects the actual strength of the proximal femur. The paper 'Perspectives on the non-invasive evaluation of femoral strength in the assessment of hip fracture risk' , published in Osteoporosis International, is authored by experts from the IOF Working Group on Hip Bone Strength as a Therapeutic Target.

Professor Serge Ferrari, corresponding author and co-chair of the IOF Working Group, noted: "With the number of debilitating hip fractures increasing worldwide, there is a pressing need to prioritize the development of accurate methods for estimating bone strength in vivo and predicting hip fracture risks. Validation of surrogate endpoints for fracture could potentially lead to shorter and less expensive clinical trials, possibly spurring innovations of new drugs and procedures which might otherwise not be investigated due to the high cost of conducting a clinical trial with fracture outcomes."

The authors extensively reviewed relevant experimental and clinical studies, examining associations between experimentally measured femoral strength and areal BMD or FEA estimated strength; surrogates of hip strength (densitometric and structural variables, and FEA); predictive power for hip fracture of computed-tomography (CT)-based and DXA-based FE approaches; effects of osteoporosis treatment on bone mass, FEA and bone strength in pre-clinical studies; and effects of osteoporosis treatment on FEA estimates of bone strength in clinical trials.

Professor Mary L. Bouxsein, first author of the paper and Working Group co-chair, stated: "The findings of this extensive review confirm that femoral areal BMD and bone strength estimates by CT-FEA are good predictors of fracture risk and are excellent candidates to replace fracture endpoints in clinical trials."

The authors also conclude that further improvements of FEA may be achieved by incorporating trabecular orientations, enhanced cortical modelling, effects of aging on bone tissue ductility, and multiple sideway fall loading conditions.
-end-
Bouxsein ML, Zysset P, Glüer CC, McClung M, Biver E, Pierroz DD, Ferrari SL on behalf of the IOF Working Group on Hip Bone Strength as a Therapeutic Target. Hip Bone Strength as a Therapeutic Target. Osteoporos Int (2020). https://doi.org/10.1007/s00198-019-05195-0https://rdcu.be/bZ6bA

About IOF

The International Osteoporosis Foundation (IOF) is the world's largest nongovernmental organization dedicated to the prevention, diagnosis and treatment of osteoporosis and related musculoskeletal diseases. IOF members, including committees of scientific researchers as well as 254 patient, medical and research societies in 100 nations, work together to make fracture prevention and healthy mobility a worldwide heath care priority. http://www.iofbonehealth.orghttp://www.worldosteoporosisday.orghttp://www.capturethefracture.org@iofbonehealth

International Osteoporosis Foundation

Related Hip Fracture Articles from Brightsurf:

Hip fracture risk linked to nanoscale bone inflexibility
New research has highlighted a preventative treatment gap in patients prone to bone fractures who are otherwise healthy.

Study seeks to explain decline in hip fracture rates
In a paper published in the Journal of the American Medical Association Internal Medicine today, researchers showed how analysis of data from the multigenerational Framingham Osteoporosis Study may in part explain why the incidence of hip fracture in the US has declined during the last two decades.

'Remarkably high' rate of suicide among elderly patients after hip fracture
Older adults who suffer a hip fracture requiring surgery are at a higher risk of suicide, suggests a study in the June 17, 2020 issue of The Journal of Bone & Joint Surgery.

Low physical function increase the risk for bone loss in older hip fracture patients
Low physical function and low muscle mass after hip fracture increased the risk for accelerated bone deterioration in older hip fracture patients.

Study reports nursing home hip fracture rates stay persistently high
A recent study of hip fracture rates in nursing homes in the U.S. reports a slight rise in the rate of hip fractures among long-stay residents in recent years.

Vitamin D boosts chances of walking after hip fracture
Senior citizens who are not vitamin D deficient have a better chance of walking after hip fracture surgery, according to a Rutgers-led study.

Does tramadol increase hip fracture risk?
An analysis published in the Journal of Bone and Mineral Research reveals that use of the pain medication tramadol was linked with a higher risk of hip fractures compared with the use of other pain medications in an analysis of a patient database from the United Kingdom.

Study finds association between therapy time, length of stay after hip fracture surgery
Researchers in the George Washington University Advanced Metrics Lab found that a hip fracture patient's length of stay in a rehabilitation facility has a greater impact on functional independence than therapy time per day

Multicomponent home-based treatments improve mobility in older adults after hip fracture
Each year more than 260,000 older Americans are hospitalized for hip fractures, a debilitating injury that can severely and permanently impact mobility.

Excellence payments to hospitals improve hip fracture care
A scheme that pays hospitals to deliver high quality care has been shown to improve the outcomes for patients with broken hips in England.

Read More: Hip Fracture News and Hip Fracture Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.