Femoral geometry as a risk factor for osteoporotic hip fracture in men and women

Medical Engineering and Physics

Volumn 30, Issue 10, 2008, Pages 1275-1286

  Gregory, Jennifer S ^a   Aspden, Richard M ^a  

^a UNIVERSITY OF ABERDEEN   (United Kingdom)

Author keywords

Active shape modelling; Fracture; Geometry; Hip; Imaging; Shape

Indexed keywords

BONE; FORECASTING; GAIT ANALYSIS; MINERALOGY; MINERALS; SILICA; SILICATE MINERALS;

ACTIVE SHAPE MODELLING; BONE MINERALS; BONE STRENGTHS; FRACTURE RISKS; HIP; HIP FRACTURES; IMAGING; METHODS OF ANALYSIS; OSTEOPOROTIC HIP FRACTURES; PROXIMAL FEMURS; RISK FACTORS; SHAPE;

FRACTURE;

AGING; BODY HEIGHT; BODY WEIGHT; BONE DENSITY; BONE STRENGTH; BONE STRUCTURE; BONE TURNOVER; FEMUR; FEMUR HEAD; FEMUR NECK; FEMUR SHAFT; FRAGILITY FRACTURE; GENDER; GEOMETRY; HIP FRACTURE; HUMAN; MORPHOMETRICS; NUTRITION; PHYSICAL ACTIVITY; PRIORITY JOURNAL; REVIEW; RISK FACTOR;

COMPUTER SIMULATION; FEMALE; FEMORAL FRACTURES; HUMANS; INCIDENCE; MALE; MODELS, BIOLOGICAL; OSTEOPOROSIS; PREVALENCE; RISK ASSESSMENT; RISK FACTORS; SEX FACTORS;

EID: 56249144816     PISSN: 13504533     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.medengphy.2008.09.002     Document Type: Review

References (128)

1. Van Staa T.P., Dennison E.M., Leufkens H.G.M., and Cooper C. Epidemiology of fractures in England and Wales. Bone 29 (2001) 517-522
2. Cummings S.R., and Melton III L.J. Osteoporosis. I. Epidemiology and outcomes of osteoporotic fractures. Lancet 359 (2002) 1761-1767
3. Osnes E.K., Lofthus C.M., Meyer H.E., Falch J.A., Nordsletten L., Cappelen I., et al. Consequences of hip fracture on activities of daily life and residential needs. Osteoporos Int 15 (2004) 567-574
4. Rudman K.E., Meakin J.R., and Aspden R.M. Compression or tension? The stress distribution in the proximal femur. BioMed Eng Online 5 (2006) 12
5. Keyak J.H., Skinner H.B., and Fleming J.A. Effect of force direction on femoral fracture load for two types of loading conditions. J Orthop Res 19 (2001) 539-544
6. Flicker L., Faulkner K.G., Hopper J.L., Green R.M., Kaymakci B., Nowson C.A., et al. Determinants of hip axis length in women aged 10-89 years: a twin study. Bone 18 (1996) 41-45
7. Arden N.K., Baker J., Hogg C., Baan K., and Spector T.D. The heritability of bone mineral density, ultrasound of the calcaneus and hip axis length: a study of postmenopausal twins. J Bone Miner Res 11 (1996) 530-534
8. Koller D.L., Liu G., Econs M.J., Hui S.L., Morin P.A., Joslyn G., et al. Genome screen for quantitative trait loci underlying normal variation in femoral structure. J Bone Miner Res 16 (2001) 985-991
9. Qureshi A.M., McGuigan F.E.A., Seymour J.D., Hutchison J.D., Reid D.M., and Ralston S.H. Association between COLIA1 Sp1 alleles and femoral neck geometry. Calcif Tissue Int (2001)
10. Karasik D., Dupuis J., Cupples L.A., Beck T.J., Mahaney M.C., Havill L.M., et al. Bivariate linkage study of proximal hip geometry and body size indices: the framingham study. Calcif Tissue Int 81 (2007) 162-173
11. Demissie S., Dupuis J., Cupples L.A., Beck T.J., Kiel D.P., and Karasik D. Proximal hip geometry is linked to several chromosomal regions: genome-wide linkage results from the framingham osteoporosis study. Bone 40 (2007) 743-750
12. Koller D.L., White K.E., Liu G., Hui S.L., Conneally P.M., Johnston C.C., et al. Linkage of structure at the proximal femur to chromosomes 3, 7, 8, and 19. J Bone Miner Res 18 (2003) 1057-1065
13. Riancho J.A., Valero C., Hernandez J.L., Olmos J.M., Paule B., Zarrabeitia A., et al. Biomechanical indices of the femoral neck estimated from the standard DXA output: age- and sex-related differences. J Clin Densitom 10 (2007) 39-45
14. Theobald T.M., Cauley J.A., Gluer C., Bunker C.H., Ukoli F.A.M., and Genant H.K. Black-white differences in hip geometry. Osteoporos Int 8 (1998) 61-67
15. Chin K., Evans M.C., Cornish J., Cundy T., and Reid I.R. Differences in hip axis and femoral neck length in premenopausal women of polynesian, Asian and European origin. Osteoporos Int 7 (1997) 344-347
16. Mikhail M.B., Vaswani A.N., and Aloia J.F. Racial differences in femoral dimensions and their relation to hip fracture. Osteoporos Int 6 (1996) 22-24
17. Nakamura T., Turner C.H., Yoshikawa T., Slemenda C.W., Peacock M., Burr D.B., et al. Do variations in hip geometry explain differences in hip fracture risk between Japanese and white Americans?. J Bone Miner Res 9 (1994) 1071-1076
18. Cummings S.R., Cauley J.A., Palermo L., Ross P.D., Wasnich R.D., Black D., et al. Racial differences in hip axis lengths might explain racial differences in rates of hip fracture. Osteoporos Int 4 (1994) 226-229
19. Greendale G.A., Young J.T., Huang M.-H., Bucur A., Wang Y., and Seeman T. Hip axis length in mid life Japanese and Caucasian U.S. residents: no evidence for an ethnic difference. Osteoporos Int 14 (2003) 320-325
20. Yan L., Crabtree N.J., Reeve J., Zhou B., Dequeker J., Nijs J., et al. Does hip strength analysis explain the lower incidence of hip fracture in the People's Republic of China?. Bone 34 (2004) 584-588
21. Wang M.C., Aguirre M., Bhudhikanok G.S., Kendall C.G., Kirsch S., Marcus R., et al. Bone mass and hip axis length in healthy Asian, black, Hispanic, and white American youths. J Bone Miner Res 12 (1997) 1922-1935
22. Macdonald H.M., New S.A., Fraser W.D., Campbell M.K., and Reid D.M. Low dietary potassium intakes and high dietary estimates of net endogenous acid production are associated with low bone mineral density in premenopausal women and increased markers of bone resorption in postmenopausal women. Am J Clin Nutr 81 (2005) 923-933
23. Macdonald H.M., New S.A., Golden M.H.N., Campbell M.K., and Reid D.M. Nutritional associations with bone loss during the menopausal transition: evidence of a beneficial effect of calcium, alcohol, and fruit and vegetable nutrients and of a detrimental effect of fatty acids. Am J Clin Nutr 79 (2004) 155-165
24. Boivin G., Lips P., Ott S.M., Harper K.D., Sarkar S., Pinette K.V., et al. Contribution of raloxifene and calcium and vitamin D3 supplementation to the increase of the degree of mineralization of bone in postmenopausal women. J Clin Endocrinol Metab 88 (2003) 4199-4205
25. Neer R.M., Arnaud C.D., Zanchetta J.R., Prince R., Gaich G.A., Reginster J.Y., et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. New Engl J Med 344 (2001) 1434-1441
26. Kiratli B.J., Smith A.E., Nauenberg T., Kallfelz C.F., and Perkash I. Bone mineral and geometric changes through the femur with immobilization due to spinal cord injury. J Rehab Res Dev 37 (2000) 225-233
27. Gregory J.S., Waarsing J.H., Day J., Pols H.A., Reijman M., Weinans H., et al. Early identification of radiographic osteoarthritis of the hip using an active shape model to quantify changes in bone morphometric features: can hip shape tell us anything about the progression of osteoarthritis?. Arthritis Rheum 56 (2007) 3634-3643
28. Goulding A., Gold E., Cannan R., Williams S., and LewisBarned N.J. Changing femoral geometry in growing girls: a cross-sectional DEXA study. Bone 19 (1996) 645-649
29. Heaney R.P., Barger-Lux M.J., Davies K.M., Ryan R.A., Johnson M.L., and Gong G. Bone dimensional change with age: interactions of genetic, hormonal and body size variables. Osteoporos Int 7 (1997) 426-431
30. Beck T.J., Looker A.C., Ruff C.B., Sievanen H., and Wahner H.W. Structural trends in the aging femoral neck and proximal shaft: analysis of the third national health and nutrition examination survey dual-energy X-ray absorptiometry data. J Bone Miner Res 15 (2000) 2297-2304
31. Anderson J.Y., and Trinkaus E. Patterns of sexual, bilateral and interpopulational variation in human femoral neck-shaft angles. J Anat 192 (1998) 279-285
32. Wolff J. Das Gesetz der Transformation der Knochen (1892), Hirschwald, Berlin
33. Skedros J.G., and Baucom S.L. Mathematical analysis of trabecular 'trajectories' in apparent trajectorial structures: the unfortunate historical emphasis on the human proximal femur. J Theor Biol 244 (2006) 15-45
34. Tobin W.J. The internal architecture of the femur and its clinical significance. J Bone Joint Surg 37-A (1955) 57-71
35. Vico L., Collet P., Guignandon A., Lafage-Proust M.H., Thomas T., Rehailia M., et al. Effects of long-term microgravity exposure on cancellous and cortical weight-bearing bones of cosmonauts. Lancet 355 (2000) 1607-1611
36. LeBlanc A.D., Spector E.R., Evans H.J., and Sibonga J.D. Skeletal responses to space flight and the bed rest analog: a review. J Musculoskelet Neuronal Interact 7 (2007) 33-47
37. Matsumoto T., Nakayama K., Kodama Y., Fuse H., Nakamura T., and Fukumoto S. Effect of mechanical unloading and reloading on periosteal bone formation and gene expression in tail-suspended rapidly growing rats. Bone (1998) 22
38. Haapasalo H., Kannus P., Sievanen H., Heinonen A., Oja P., and Vuori I. Long-term unilateral loading and bone mineral density and content in female squash players. Calcif Tissue Int 54 (1994) 249-255
39. Haapasalo H., Kannus P., Nen H., Pasanen M., Uusi-Rasi K., Heinonen A., et al. Effect of long-term unilateral activity on bone mineral density of female junior tennis players. J Bone Miner Res 13 (1998) 310-319
40. Bass S.L., Saxon L., Daly R.M., Turner C.H., Robling A.G., Seeman E., et al. The effect of mechanical loading on the size and shape of bone in pre-, peri- and postpubertal girls: a study in tennis players. J Bone Miner Res 17 (2002) 2274-2280
41. Humphrey G.M. The angle of the neck with the shaft of the femur at different periods of life and under different circumstances. J Anat Physiol 23 (1889) 273
42. Amstutz H., and Wilson P. Dysgenesis of the proximal femur (Coxa Vara) and its surgical management. J Bone Joint Surg Am 44 (1953) 1-24
43. Meier D.E., Orwoll E.S., and Jones J.M. Marked disparity between trabecular and cortical bone loss with age in healthy men. Measurement by vertebral computed tomography and radial photon absorptiometry. Ann Int Med 101 (1984) 605-612
44. Merrill V. Atlas of roentgenographic positions and standard radiologic procedures (1975), The C.V. Mosby Company
45. Cheng X.G., Nicholson P.H.F., Boonen S., Brys P., Lowet G., Nijs J., et al. Effects of anteversion on femoral bone mineral density and geometry measured by dual energy X-ray absorptiometry: a cadaver study. Bone 21 (1997) 113-117
46. Karlsson K.M., Sernbo I., Obrant K.J., RedlundJohnell I., and Johnell O. Femoral neck geometry and radiographic signs of osteoporosis as predictors of hip fracture. Bone 18 (1996) 327-330
47. Faulkner K.G., Cummings S.R., Black D., Palermo L., Glüer C.-C., and Genant H.K. Simple measurement of femoral geometry predicts hip fracture: the study of osteoporotic fractures. J Bone Miner Res 8 (1993) 1211-1217
48. Faulkner K.G., McClung M., and Cummings S.R. Automated evaluation of hip axis length for predicting hip fracture. J Bone Miner Res 9 (1994) 1065-1070
49. Gnudi S., Ripamonti C., Lisi L., Fini M., Giardino R., and Giavaresi G. Proximal femur geometry to detect and distinguish femoral neck fractures from trochanteric fractures in postmenopausal women. Osteoporos Int 13 (2002) 69-73
50. Boonen S., Koutri R., Dequeker J., Aerssens J., Lowet G., Nijs J., et al. Measurement of femoral geometry in Type-I and Type-II osteoporosis-differences in hip axis length consistent with heterogeneity in the pathogenesis of osteoporotic fractures. J Bone Miner Res 10 (1995) 1908-1912
51. Rosso R., and Mikhail M.B. Hip axis length in an Italian osteoporotic population. Br J Radiol 73 (2000) 969-972
52. Gnudi S., Ripamonti C., Gualtieri G., and Malavolta N. Geometry of proximal femur in the prediction of hip fracture in osteoporotic women. Br J Radiol 72 (1999) 729-733
53. Faulkner K.G., Wacker W.K., Barden H.S., Simonelli C., Burke P.K., Ragi S., et al. Femur strength index predicts hip fracture independent of bone density and hip axis length. Osteoporos Int 17 (2006) 593-599
54. Frisoli J., Paula A.P., Pinheiro M., Szejnfeld V.L., monte Piovezan R., Takata E., et al. Hip axis length as an independent risk factor for hip fracture independently of femural bone mineral density in Caucasian elderly Brazilian women. Bone 37 (2005) 871-875
55. Bergot C., Bousson V., Meunier A., Laval-Jeantet M., and Laredo J.D. Hip fracture risk and proximal femur geometry from DXA scans. Osteoporos Int 13 (2002) 542-550
56. Duboeuf F., Hans D., Schott A.M., Kotzki P.O., Favier F., Marcelli C., et al. Different morphometric and densitometric parameters predict cervical and trochanteric hip fracture: the EPIDOS study. J Bone Miner Res 12 (1997) 1895-1902
57. Alonso C.G., Diaz M.D., Carranza F.H., Cano R.P., and Perez A.D. Femoral bone mineral density, neck-shaft angle and mean femoral neck width as predictors of hip fracture in men and women. Osteoporos Int 11 (2000) 714-720
58. Pande, O'Neill T.W., Pritchard C., Scott D.L., and Woolf A.D. Bone mineral density, hip axis length and risk of hip fracture in men: results from the Cornwall hip fracture study. Osteoporos Int 11 (2000) 866-870
59. Partanen J., Jamsa T., and Jalovaara P. Influence of the upper femur and pelvic geometry on the risk and type of hip fractures. J Bone Miner Res 16 (2001) 1540-1546
60. Dretakis E.K., Papakitsou E., Kontakis G.M., Dretakis K., Psarakis S., and Steriopoulos K.A. Bone mineral density, body mass index, and hip axis length in postmenopausal Cretan women with cervical and trochanteric fractures. Calcif Tissue Int 64 (1999) 257-258
61. Center J.R., Nguyen T.V., Pocock N.A., Noakes K.A., Kelly P.J., Eisman J.A., et al. Femoral neck axis length, height loss and risk of hip fracture in males and females. Osteoporos Int 8 (1998) 75-81
62. Faulkner K.G. Simple measurement of femoral geometry predicts hip fracture: the study of osteoporotic fractures (abstract and commentary). J Bone Miner Res 18 (2003) S14
63. El-Kaissi S., Pasco J.A., Henry M.J., Panahi S., Nicholson J.G., Nicholson G.C., et al. Femoral neck geometry and hip fracture risk: the Geelong osteoporosis study. Osteoporos Int 16 (2005) 1299-1303
64. Yang R.S., Wang S.S., and Liu T.K. Proximal femoral dimension in elderly Chinese women with hip fractures in Taiwan. Osteoporos Int 10 (1999) 109-113
65. Calis H.T., Eryavuz M., and Calis M. Comparison of femoral geometry among cases with and without hip fractures. Yonsei Med J 45 (2004) 901-907
66. Cheng X.G., Lowet G., Boonen S., Nicholson P.H.F., Brys P., Nijs J., et al. Assessment of the strength of proximal femur in vitro: relationship to femoral bone mineral density and femoral geometry. Bone 20 (1997) 213-218
67. Kukla C., Gaebler C., Pichl R.W., Prokesch R., Heinze G., and Heinz T. Predictive geometric factors in a standardized model of femoral neck fracture: experimental study of cadaveric human femurs. Injury 33 (2002) 427-433
68. Lochmüller E.M., Groll O., Kuhn V., and Eckstein F. Mechanical strength of the proximal femur as predicted from geometric and densitometric bone properties at the lower limb versus the distal radius. Bone 30 (2002) 207-216
69. Le Bras A., Kolta S., Soubrane P., Skalli W., Roux C., and Mitton D. Assessment of femoral neck strength by 3-dimensional X-ray absorptiometry. J Clin Densitom 9 (2006) 425-430
70. Seeman E., Duan Y., Fong C., and Edmonds J. Fracture site-specific deficits in bone size and volumetric density in men with spine or hip fractures. J Bone Miner Res 16 (2001) 120-127
71. Karlamangla A.S., Barret-Connor E., Young J., and Greendale G.A. Hip fracture risk assessment using composite indices of femoral neck strength: the Rancho Bernardo study. Osteoporos Int 15 (2004) 62-70
72. Ahlborg H.G., Nguyen N.D., Nguyen T.V., Center J.R., and Eisman J.A. Contribution of hip strength indices to hip fracture risk in elderly men and women. J Bone Miner Res 20 (2005) 1820-1827
73. Bonnaire F.A., Buitrago-Tellez C., Schmal H., tze B., and Weber A.T. Correlation of bone density and geometric parameters to the mechanical strength of the femoral neck. Injury (2002) 33
74. Peacock M., Liu G., Carey M., Ambrosius W., Turner C.H., Hui S., et al. Bone mass and structure at the hip in men and women over the age of 60 years. Osteoporos Int 8 (1998) 231-239
75. Lekamwasam S., and Lenora J. Age-related trends in hip geometry in Sri Lankan women: a cross-sectional study. J Bone Miner Metab 25 (2007) 431-435
76. Beck T.J. Extending DXA beyond bone mineral density: understanding hip structure analysis. Curr Osteoporos Reports 5 (2007) 49-55
77. Pulkkinen P., Eckstein F., ller E.M., Kuhn V., and Jämsä T. Association of geometric factors and failure load level with the distribution of cervical vs. trochanteric hip fractures. J Bone Miner Res 21 (2006) 895-901
78. Gluer C.C., Cummings S.R., Pressman A., Li J., Gluer K., Faulkner K.G., et al. Prediction of hip-fractures from pelvic radiographs-the study of osteoporotic fractures. J Bone Miner Res 9 (1994) 671-677
79. Bouxsein M.L., Szulc P., Munoz F., Thrall E., Sornay-Rendu E., and Delmas P.D. Contribution of trochanteric soft tissues to fall force estimates, the factor of risk, and prediction of hip fracture risk. J Bone Miner Res 22 (2007) 825-831
80. Pinilia T.P., Boardman K.C., Bouxsein M.L., Myers E.R., and Hayes W.C. Impact direction from a fall influences the failure load of the proximal femur as much as age-related bone loss. Calcif Tiss Int 58 (1996) 231-235
81. Riggs B.L., Melton III L.J., Robb R.A., Camp J.J., Atkinson E.J., Oberg A.L., et al. Population-based analysis of the relationship of whole bone strength indices and fall-related loads to age- and sex-specific patterns of hip and wrist fractures. J Bone Miner Res 21 (2006) 315-323
82. Patton M.S., Duthie R.A., and Sutherland A.G. Proximal femoral geometry and hip fractures. Acta Orthopaedica Belgica 72 (2006) 51-54
83. Pocock N.A., Noakes K.A., Majerovic Y., and Griffiths M.R. Magnification error of femoral geometry using fan beam densitometers. Calcif Tiss Int 60 (1997) 8-10
84. Faulkner K.G., Genant H.K., and McClung M. Bilateral comparison of femoral bone density and hip axis length from single and fan beam DXA scans. Calcif Tiss Int 56 (1995) 26-31
85. Kolta S., Le Bras A., Mitton D., Bousson V., De Guise J.A., Fechtenbaum J., et al. Three-dimensional X-ray absorptiometry (3D-XA): a method for reconstruction of human bones using a dual X-ray absorptiometry device. Osteoporos Int 16 (2005) 969-976
86. Duthie R.A., Bruce M.F., and Hutchison J.D. Changing proximal femoral geometry in north east Scotland: an osteometric study. BMJ 316 (1998) 1498
87. Reid I.R., Chin K., Evans M.C., and Jones J.G. Relation between increase length of hip axis in older women between 1950s and 1960s and increase in age specific rates of hip fracture. BMJ 309 (1994) 508-509
88. Michelotti J., and Clark J. Femoral neck length and hip fracture risk. J Bone Miner Res 14 (1999) 1714-1720
89. Gregory J.S., Testi D., Stewart A., Undrill P.E., Reid D.M., and Aspden R.M. A method for assessment of the shape of the proximal femur and its relationship to osteoporotic hip fracture. Osteoporos Int 15 (2004) 5-11
90. O'Neill T.W., Grazio S., Spector T.D., and Silman A.J. Geometric measurements of the proximal femur in UK women: secular increase between the late 1950s and early 1990s. Osteoporos Int 6 (1996) 136-140
91. Looker A.C., Beck T.J., and Orwoll E.S. Does body size account for gender differences in femur bone density and geometry?. J Bone Miner Res 16 (2001) 1291-1299
92. Koch J.C. The laws of bone architecture. Am J Anat 21 (1917) 177-297
93. Mourtada F.A., Beck T.J., Hauser D.L., Ruff C.B., and Bao G. Curved beam model of the proximal femur for estimating stress using dual-energy X-ray absorptiometry derived structural geometry. J Orthop Res 14 (1996) 483-492
94. Mayhew P., Kaptoge S., Loveridge N., Power J., Kroger H.P.J., Parker M., et al. Discrimination between cases of hip fracture and controls is improved by hip structural analysis compared to areal bone mineral density. An ex vivo study of the femoral neck. Bone 34 (2004) 352-361
95. Testi D., Viceconti M., Baruffaldi F., and Cappello A. Risk of fracture in elderly patients: a new predictive index based on bone mineral density and finite element analysis. Comput Methods Programs Biomed 60 (1999) 23-33
96. Keyak J.H., Rossi S.A., Jones K.A., Les C.M., and Skinner H.B. Prediction of fracture location in the proximal femur using finite element models. Med Eng Phys 23 (2001) 657-664
97. Keyak J.H., and Falkinstein Y. Comparison of in situ and in vitro CT scan-based finite element model predictions of proximal femoral fracture load. Med Eng Phys 25 (2003) 781-787
98. Duchemin L., Mitton D., Jolivet E., Bousson V., and Laredo J.D. An anatomical subject-specific FE-model for hip fracture load prediction. Computer Methods Biomech Biomed Eng 11 (2008) 105-111
99. Cody D.D., Gross G.J., Hou F.J., Spencer H.J., Goldstein S.A., and Fyhrie D.P. Femoral strength is better predicted by finite element models than QCT and DXA. J Biomech 32 (1999) 1013-1017
100. Peacock M., Turner C.H., Liu G., Manatunga A.K., Timmerman L., and Johnston C.C. Better discrimination of hip fracture using bone-density, geometry and architecture. Osteoporos Int 5 (1995) 167-173
101. Beck T.J., Ruff C.B., and Bissessur K. Age related changes in female femoral neck geometry: implications for bone strength. Calcif Tissue Int 53 (1993) S41-S46
102. Kaptoge S., Dalzell N., Loveridge N., Beck T.J., Khaw K.T., and Reeve J. Effects of gender, anthropometric variables, and aging on the evolution of hip strength in men and women aged over 65. Bone 32 (2003) 561-570
103. Rivadeneira F., Zillikens M.C., De Laet C.E.D.H., Hofman A., Uitterlinden A.G., Beck T.J., et al. Femoral neck BMD is a strong predictor of hip fracture susceptibility in elderly men and women because it detects cortical bone instability: the Rotterdam study. J Bone Miner Res 22 (2007) 1781-1790
104. Crabtree N.J., Kroger H., Martin A., Pols H.A.P., Lorenc R., Nijs J., et al. Improving risk assessment: hip geometry, bone mineral distribution and bone strength in hip fracture cases and controls. The EPOS study. Osteoporos Int 13 (2002) 48-54
105. Keyak J.H. Improved prediction of proximal femoral fracture load using nonlinear finite element models. Med Eng Phys 23 (2001) 165-173
106. Lotz J.C., Cheal E.J., and Hayes W.C. Fracture prediction for the proximal femur using finite element models. Part I. Linear analysis. J Biomech Eng 113 (1991) 353-360
107. Lotz J.C., Cheal E.J., and Hayes W.C. Stress distributions within the proximal femur during gait and falls: implications for osteoporotic fracture. Osteoporos Int 5 (1995) 252-261
108. Testi D., Viceconti M., Cappello A., Gnudi S., and Toni A. Fracture prediction for the femoral neck using finite element models. Chir Organi Mov 86 (2001) 59-64
109. Cootes TF, Taylor CJ. Active shape models. In: Hogg D, Boyle R, editors, 3rd British machine vision conference, Springer-Verlag, Sept. 1992 266-275.
110. Cootes T.F., Hill A., Taylor C.J., and Haslam J. Use of active shape models for locating structures in medical images. Image Vision Comput 12 (1994) 355-365
111. Gregory J.S., Testi D., Stewart A., Undrill P.E., Reid D.M., and Aspden R.M. A method for assessment of the shape of the proximal femur and its relationship to osteoporotic hip fracture. Osteoporos Int 15 (2003) 11
112. Roberts M.G., Cootes T.F., and Adams J.E. Vertebral shape: automatic measurement with dynamically sequenced active appearance models. Med Image Comput Comput Assist Interv Int Conf 8 (2005) 733-740
113. Redhead A.L., Kotcheff A.C.W., Taylor C.J., Porter M.L., and Hukins D.W.L. An automated method for assessing routine radiographs of patients with total hip replacements. Proc Inst Mech Eng Part H: J Eng Med 221 (1997) 145-154
114. Gandy S.J., Brett A.D., Dieppe P.A., Keen M.C., Maciewicz R.A., Taylor C.J., et al. Measurement of cartilage volumes in rheumatoid arthritis using MRI. Br J Radiol 78 (2005) 39-45
115. Smyth P.P., Taylor C.J., and Adams J.E. Vertebral shape: automatic measurement with active shape models. Radiology 211 (1999) 571-578
116. Thodberg H.H., and Rosholm A. Application of the active shape model in a commercial medical device for bone densitometry. Image Vision Comput 21 (2003) 1155-1161
117. Long L.R., and Thoma G.R. Use of shape models to search digitized spine X-rays. Proceedings of the 13th IEEE symposium on computer-based medical systems (CBMS'00) (2001) 13
118. Rudman K.E., Aspden R.M., and Meakin J.R. Compression or tension? The stress distribution in the proximal femur. BioMed Eng Online (2006) 5
119. Pulkkinen P., Partanen J., Jalovaara P., and Jämsä T. Combination of bone mineral density and upper femur geometry improves the prediction of hip fracture. Osteoporos Int 15 (2004) 274-280
120. Genant H.K., Gordon C., Jiang Y., Link T.M., Didier H., Majumdar S., et al. Advanced imaging of the macrostructure and microstructure of bone. Hormone Res 54 (2000) 24-30
121. Thorpe J.A., and Steel S.A. Image resolution of the lunar expert-XL. Osteoporos Int 10 (1999) 95-101
122. Genant H.K., Li J., Wu C.Y., and Shepherd J.A. Vertebral fractures in osteoporosis: a new method for clinical assessment. J Clin Densitom 3 (2000) 281-290
123. Blake G.M., and Fogelman I. Technical principles of dual energy X-ray absorptiometry. Seminars in Nuclear Med 27 (1997) 210-228
124. Ammann P., and Rizzoli R. Bone strength and its determinants. Osteoporos Int 14 (2003) S13-S18
125. Chappard D., Legrand E., Basle M.F., and Audran M. Measuring Trabecular Bone Architecture By Image Analysis of Histological Sections. Micro anal (1997) 23-25
126. Newitt D.C., Majumdar S., Van Rietbergen B., von Ingersleben G., Harris S.T., Genant H.K., et al. In Vivo assessment of architecture and micro-finite element analysis derived indices of mechanical properties of trabecular bone in the radius. Osteoporos Int 13 (2002) 6-17
127. Dougherty G., and Henebry G.M. Lacunarity analysis of spatial pattern in CT images of vertebral trabecular bone for assessing osteoporosis. Med Eng Phys 24 (2002) 129-138
128. Majumdar S., and Genant H.K. High resolution magnetic resonance imaging of trabecular structure. Euro Radiol 7 (1997) S51-S55