Development of Subject-Specific Proximal Femur Finite Element Models Of Older Adults with Obesity to Evaluate the Effects of Weight Loss on Bone Strength

Overview

Journal J Osteoporos Phys Act

Publisher Omics Publishing Group

Date 2018 Apr 24

PMID 29683141

Citations 8

Authors

S L Schoell

A A Weaver

D P Beavers

Leon Lenchik

A P Marsh

W J Rejeski

J D Stitzel

K M Beavers

Affiliations

Soon will be listed here.

Abstract

Study Background: Recommendation of intentional weight loss in older adults remains controversial, due in part to the loss of bone mineral density (BMD) known to accompany weight loss. While finite element (FE) models have been used to assess bone strength, these methods have not been used to study the effects of weight loss. The purpose of this study is to develop subject-specific FE models of the proximal femur and study the effect of intentional weight loss on bone strength.

Methods: Computed tomography (CT) scans of the proximal femur of 25 overweight and obese (mean BMI=29.7 ± 4.0 kg/m), older adults (mean age=65.6 ± 4.1 years) undergoing an 18-month intentional weight loss intervention were obtained at baseline and post-intervention. Measures of volumetric BMD (vBMD) and variable cortical thickness were derived from each subject CT scan and directly mapped to baseline and post-intervention models. Subject-specific FE models were developed using morphing techniques. Bone strength was estimated through simulation of a single-limb stance and sideways fall configuration.

Results: After weight loss intervention, there were significant decreases from baseline to 18 months in vBMD (total hip: -0.024 ± 0.013 g/cm; femoral neck: -0.012 ± 0.014 g/cm), cortical thickness (total hip: -0.044 ± 0.032 mm; femoral neck: -0.026 ± 0.039 mm), and estimated strength (stance: -0.15 ± 0.12 kN; fall: -0.04 ± 0.06 kN). Adjusting for baseline bone measures, body mass, and gender, correlations were found between weight change and change in total hip and femoral neck cortical thickness (all p<0.05). For every 1 kilogram of body mass lost cortical thickness in the total hip and femoral neck decreased by 0.003 mm and 0.004 mm, respectively. No significant correlations were present for the vBMD or strength data.

Conclusion: The developed subject-specific FE models could be used to better understand the effects of intentional weight loss on bone health.

Citing Articles

Physical activity attenuates the excess mortality risk from prolonged sitting time among adults with osteoporosis or osteopenia.

Liang Z, Lan J, Sun X, Guo R, Tian Y, Wang Y Endocrine. 2024; 85(3):1365-1378.

PMID: 38760616 DOI: 10.1007/s12020-024-03871-8.

Strategies to reduce the onset of sleeve gastrectomy associated bone loss (STRONG BONES): Trial design and methods.

Stapleton J, Ard J, Beavers D, Cogdill L, Fernandez A, Howard M Contemp Clin Trials Commun. 2023; 34:101181.

PMID: 37456507 PMC: 10344650. DOI: 10.1016/j.conctc.2023.101181.

Effect of exercise modality and weight loss on changes in muscle and bone quality in older adults with obesity.

Madrid D, Beavers K, Walkup M, Ambrosius W, Rejeski W, Marsh A Exp Gerontol. 2023; 174:112126.

PMID: 36796657 PMC: 10033433. DOI: 10.1016/j.exger.2023.112126.

Acetabular Implant Finite Element Simulation with Customised Estimate of Bone Properties.

Soloviev D, Maslov L, Zhmaylo M Materials (Basel). 2023; 16(1).

PMID: 36614737 PMC: 9822217. DOI: 10.3390/ma16010398.

Caloric Intake in Renal Patients: Repercussions on Mineral Metabolism.

Vidal A, Rios R, Pineda C, Lopez I, Raya A, Aguilera-Tejero E Nutrients. 2020; 13(1).

PMID: 33374582 PMC: 7822489. DOI: 10.3390/nu13010018.

References

Nguyen N, Pongchaiyakul C, Center J, Eisman J, Nguyen T . Identification of high-risk individuals for hip fracture: a 14-year prospective study. J Bone Miner Res. 2005; 20(11):1921-8. DOI: 10.1359/JBMR.050520. View

Vavalle N, Davis M, Stitzel J, Gayzik F . Quantitative Validation of a Human Body Finite Element Model Using Rigid Body Impacts. Ann Biomed Eng. 2015; 43(9):2163-74. DOI: 10.1007/s10439-015-1286-7. View

Keyak J, Rossi S, Jones K, Skinner H . Prediction of femoral fracture load using automated finite element modeling. J Biomech. 1998; 31(2):125-33. DOI: 10.1016/s0021-9290(97)00123-1. View

Schileo E, Taddei F, Cristofolini L, Viceconti M . Subject-specific finite element models implementing a maximum principal strain criterion are able to estimate failure risk and fracture location on human femurs tested in vitro. J Biomech. 2007; 41(2):356-67. DOI: 10.1016/j.jbiomech.2007.09.009. View

Allison S, Poole K, Treece G, Gee A, Tonkin C, Rennie W . The Influence of High-Impact Exercise on Cortical and Trabecular Bone Mineral Content and 3D Distribution Across the Proximal Femur in Older Men: A Randomized Controlled Unilateral Intervention. J Bone Miner Res. 2015; 30(9):1709-16. DOI: 10.1002/jbmr.2499. View

Treece G, Poole K, Gee A . Imaging the femoral cortex: thickness, density and mass from clinical CT. Med Image Anal. 2012; 16(5):952-65. PMC: 3417239. DOI: 10.1016/j.media.2012.02.008. View

Link T . Osteoporosis imaging: state of the art and advanced imaging. Radiology. 2012; 263(1):3-17. PMC: 3309802. DOI: 10.1148/radiol.2633201203. View

Schoell S, Weaver A, Vavalle N, Stitzel J . Age- and sex-specific thorax finite element model development and simulation. Traffic Inj Prev. 2015; 16 Suppl 1:S57-65. DOI: 10.1080/15389588.2015.1005208. View

Lang T, LeBlanc A, Evans H, Lu Y, Genant H, Yu A . Cortical and trabecular bone mineral loss from the spine and hip in long-duration spaceflight. J Bone Miner Res. 2004; 19(6):1006-12. DOI: 10.1359/JBMR.040307. View

10.

Brown T, Vrahas M . The apparent elastic modulus of the juxtarticular subchondral bone of the femoral head. J Orthop Res. 1984; 2(1):32-8. DOI: 10.1002/jor.1100020106. View

11.

Rejeski W, Ambrosius W, Burdette J, Walkup M, Marsh A . Community Weight Loss to Combat Obesity and Disability in At-Risk Older Adults. J Gerontol A Biol Sci Med Sci. 2017; 72(11):1547-1553. PMC: 5861918. DOI: 10.1093/gerona/glw252. View

12.

Hangartner T, JOHNSTON C . Influence of fat on bone measurements with dual-energy absorptiometry. Bone Miner. 1990; 9(1):71-81. DOI: 10.1016/0169-6009(90)90101-k. View

13.

Keyak J . Improved prediction of proximal femoral fracture load using nonlinear finite element models. Med Eng Phys. 2001; 23(3):165-73. DOI: 10.1016/s1350-4533(01)00045-5. View

14.

Viceconti M, Bellingeri L, Cristofolini L, Toni A . A comparative study on different methods of automatic mesh generation of human femurs. Med Eng Phys. 1998; 20(1):1-10. DOI: 10.1016/s1350-4533(97)00049-0. View

15.

Ensrud K, Ewing S, Stone K, Cauley J, Bowman P, Cummings S . Intentional and unintentional weight loss increase bone loss and hip fracture risk in older women. J Am Geriatr Soc. 2003; 51(12):1740-7. DOI: 10.1046/j.1532-5415.2003.51558.x. View

16.

Untaroiu C, Yue N, Shin J . A finite element model of the lower limb for simulating automotive impacts. Ann Biomed Eng. 2012; 41(3):513-26. DOI: 10.1007/s10439-012-0687-0. View

17.

Schoell S, Weaver A, Urban J, Jones D, Stitzel J, Hwang E . Development and Validation of an Older Occupant Finite Element Model of a Mid-Sized Male for Investigation of Age-related Injury Risk. Stapp Car Crash J. 2015; 59:359-83. DOI: 10.4271/2015-22-0014. View

18.

Treece G, Gee A . Independent measurement of femoral cortical thickness and cortical bone density using clinical CT. Med Image Anal. 2014; 20(1):249-64. DOI: 10.1016/j.media.2014.11.012. View

19.

. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser. 1994; 843:1-129. View

20.

Keller T, Mao Z, Spengler D . Young's modulus, bending strength, and tissue physical properties of human compact bone. J Orthop Res. 1990; 8(4):592-603. DOI: 10.1002/jor.1100080416. View