At present, the current gold-standard for osteoporosis diagnosis is based on bone mineral density (BMD) measurement, which, however, has been demonstrated to poorly estimate fracture risk. Further parameters in the hands of the clinicians are represented by the hip structural analysis (HSA) variables, which include geometric information of the proximal femur cross section. The purpose of this study was to investigate the suitability of HSA parameters as additional hip fracture risk predictors. With this aim, twenty-eight three-dimensional patient-specific models of the proximal femur were built from computed tomography (CT) images and a sideways fall condition was reproduced by finite element (FE) analyses. A tensile or compressive predominance based on minimum and maximum principal strains was determined at each volume element and a risk factor (RF) was calculated. The power of HSA variables combinations to predict the maximum superficial RF values was assessed by multivariate linear regression analysis. The optimal regression model, identified through the Akaike information criterion (AIC), only comprises two variables: the buckling ratio (BR) and the neck-shaft angle (NSA). In order to validate the study, the model was tested on two additional patients who suffered a hip fracture after a fall. The results classified the patients in the high risk level, confirming the prediction power of the adopted model.
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November 2018
Research-Article
Osteoporotic Hip Fracture Prediction: Is T-Score-Based Criterion Enough? A Hip Structural Analysis-Based Model
Alessandra Aldieri,
Alessandra Aldieri
PolitoBIOMed Lab,
Department of Mechanical and
Aerospace Engineering,
Politecnico di Torino,
Corso Duca degli Abruzzi,
Turin 24-10129, Italy
e-mail: alessandra.aldieri@polito.it
Department of Mechanical and
Aerospace Engineering,
Politecnico di Torino,
Corso Duca degli Abruzzi,
Turin 24-10129, Italy
e-mail: alessandra.aldieri@polito.it
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Mara Terzini,
Mara Terzini
PolitoBIOMed Lab,
Department of Mechanical and
Aerospace Engineering,
Politecnico di Torino,
Corso Duca degli Abruzzi,
Turin 24-10129, Italy
e-mail: mara.terzini@polito.it
Department of Mechanical and
Aerospace Engineering,
Politecnico di Torino,
Corso Duca degli Abruzzi,
Turin 24-10129, Italy
e-mail: mara.terzini@polito.it
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Giangiacomo Osella,
Giangiacomo Osella
Department of Internal Medicine,
San Luigi Gonzaga University Hospital,
Regione Gonzole 10,
Orbassano 10043, Italy
e-mail: giangiacomo.osella@gmail.com
San Luigi Gonzaga University Hospital,
Regione Gonzole 10,
Orbassano 10043, Italy
e-mail: giangiacomo.osella@gmail.com
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Adriano M. Priola,
Adriano M. Priola
Department of Diagnostic Imaging,
San Luigi Gonzaga University Hospital,
University of Torino,
Regione Gonzole 10,
Orbassano 10043, Italy
e-mail: adriano.priola@inwind.it
San Luigi Gonzaga University Hospital,
University of Torino,
Regione Gonzole 10,
Orbassano 10043, Italy
e-mail: adriano.priola@inwind.it
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Alberto Angeli,
Alberto Angeli
Department of Internal Medicine,
San Luigi Gonzaga University Hospital,
University of Torino,
Regione Gonzole 10,
Orbassano 10043, Italy
e-mail: alberto.angeli@unito.it
San Luigi Gonzaga University Hospital,
University of Torino,
Regione Gonzole 10,
Orbassano 10043, Italy
e-mail: alberto.angeli@unito.it
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Andrea Veltri,
Andrea Veltri
Department of Diagnostic Imaging,
San Luigi Gonzaga University Hospital,
University of Torino,
Regione Gonzole 10,
Orbassano 10043, Italy
e-mail: veltri.andrea@gmail.com
San Luigi Gonzaga University Hospital,
University of Torino,
Regione Gonzole 10,
Orbassano 10043, Italy
e-mail: veltri.andrea@gmail.com
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Alberto L. Audenino,
Alberto L. Audenino
PolitoBIOMed Lab,
Department of Mechanical and
Aerospace Engineering,
Politecnico di Torino,
Corso Duca degli Abruzzi,
Turin 24-10129, Italy
e-mail: alberto.audenino@polito.it
Department of Mechanical and
Aerospace Engineering,
Politecnico di Torino,
Corso Duca degli Abruzzi,
Turin 24-10129, Italy
e-mail: alberto.audenino@polito.it
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Cristina Bignardi
Cristina Bignardi
PolitoBIOMed Lab,
Department of Mechanical and
Aerospace Engineering,
Politecnico di Torino,
Corso Duca degli Abruzzi,
Turin 24-10129, Italy
e-mail: cristina.bignardi@polito.it
Department of Mechanical and
Aerospace Engineering,
Politecnico di Torino,
Corso Duca degli Abruzzi,
Turin 24-10129, Italy
e-mail: cristina.bignardi@polito.it
Search for other works by this author on:
Alessandra Aldieri
PolitoBIOMed Lab,
Department of Mechanical and
Aerospace Engineering,
Politecnico di Torino,
Corso Duca degli Abruzzi,
Turin 24-10129, Italy
e-mail: alessandra.aldieri@polito.it
Department of Mechanical and
Aerospace Engineering,
Politecnico di Torino,
Corso Duca degli Abruzzi,
Turin 24-10129, Italy
e-mail: alessandra.aldieri@polito.it
Mara Terzini
PolitoBIOMed Lab,
Department of Mechanical and
Aerospace Engineering,
Politecnico di Torino,
Corso Duca degli Abruzzi,
Turin 24-10129, Italy
e-mail: mara.terzini@polito.it
Department of Mechanical and
Aerospace Engineering,
Politecnico di Torino,
Corso Duca degli Abruzzi,
Turin 24-10129, Italy
e-mail: mara.terzini@polito.it
Giangiacomo Osella
Department of Internal Medicine,
San Luigi Gonzaga University Hospital,
Regione Gonzole 10,
Orbassano 10043, Italy
e-mail: giangiacomo.osella@gmail.com
San Luigi Gonzaga University Hospital,
Regione Gonzole 10,
Orbassano 10043, Italy
e-mail: giangiacomo.osella@gmail.com
Adriano M. Priola
Department of Diagnostic Imaging,
San Luigi Gonzaga University Hospital,
University of Torino,
Regione Gonzole 10,
Orbassano 10043, Italy
e-mail: adriano.priola@inwind.it
San Luigi Gonzaga University Hospital,
University of Torino,
Regione Gonzole 10,
Orbassano 10043, Italy
e-mail: adriano.priola@inwind.it
Alberto Angeli
Department of Internal Medicine,
San Luigi Gonzaga University Hospital,
University of Torino,
Regione Gonzole 10,
Orbassano 10043, Italy
e-mail: alberto.angeli@unito.it
San Luigi Gonzaga University Hospital,
University of Torino,
Regione Gonzole 10,
Orbassano 10043, Italy
e-mail: alberto.angeli@unito.it
Andrea Veltri
Department of Diagnostic Imaging,
San Luigi Gonzaga University Hospital,
University of Torino,
Regione Gonzole 10,
Orbassano 10043, Italy
e-mail: veltri.andrea@gmail.com
San Luigi Gonzaga University Hospital,
University of Torino,
Regione Gonzole 10,
Orbassano 10043, Italy
e-mail: veltri.andrea@gmail.com
Alberto L. Audenino
PolitoBIOMed Lab,
Department of Mechanical and
Aerospace Engineering,
Politecnico di Torino,
Corso Duca degli Abruzzi,
Turin 24-10129, Italy
e-mail: alberto.audenino@polito.it
Department of Mechanical and
Aerospace Engineering,
Politecnico di Torino,
Corso Duca degli Abruzzi,
Turin 24-10129, Italy
e-mail: alberto.audenino@polito.it
Cristina Bignardi
PolitoBIOMed Lab,
Department of Mechanical and
Aerospace Engineering,
Politecnico di Torino,
Corso Duca degli Abruzzi,
Turin 24-10129, Italy
e-mail: cristina.bignardi@polito.it
Department of Mechanical and
Aerospace Engineering,
Politecnico di Torino,
Corso Duca degli Abruzzi,
Turin 24-10129, Italy
e-mail: cristina.bignardi@polito.it
Manuscript received January 26, 2018; final manuscript received May 30, 2018; published online August 20, 2018. Assoc. Editor: Anna Pandolfi.
J Biomech Eng. Nov 2018, 140(11): 111004 (8 pages)
Published Online: August 20, 2018
Article history
Received:
January 26, 2018
Revised:
May 30, 2018
Citation
Aldieri, A., Terzini, M., Osella, G., Priola, A. M., Angeli, A., Veltri, A., Audenino, A. L., and Bignardi, C. (August 20, 2018). "Osteoporotic Hip Fracture Prediction: Is T-Score-Based Criterion Enough? A Hip Structural Analysis-Based Model." ASME. J Biomech Eng. November 2018; 140(11): 111004. https://doi.org/10.1115/1.4040586
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