Relationships between femoral strength evaluated by nonlinear finite element analysis and BMD, material distribution and geometric morphology

He Gong, Ming Zhang, Yubo Fan, Wai Leung Kwok, Ping Chung Leung

Research output: Journal article publicationJournal articleAcademic researchpeer-review

44 Citations (Scopus)


Precise quantification of femur strength and accurate assessment of hip fracture risk would help physicians to identify individuals with high risk and encourage them to take preventive interventions. A major contributing factor of hip fracture is the reduction of hip strength, determined by the bone quality. Bone mineral density (BMD) alone cannot determine bone strength accurately. In this paper, subject-specific quantitative computer tomography (QCT) image-based finite element analyses were conducted to identify the quantitative relationships between femoral strength and BMD, material distribution and geometric morphology. Sixty-six subjects with QCT data of hip region were selected fromtheMrOS cohorts in Hong Kong. Subject-specific nonlinear finite element models were developed to predict strengths of proximal femurs. The models took non-linear elasto-plasticity and heterogeneity of bone tissues into consideration and derived bone strengths with proper bone failure criteria.Fromfinite element analysis (FEA), relationships between femoral strength and BMD, material distribution, and geometric parameters were determined. Results showed that FEA-predicted femoral strength was highly correlated with BMD, material distribution, height, weight, diameters of femoral head (HD), and femoral neck (ND), as well as the moment arm for femoral neck bending- offset (OFF). Through principal components analysis, three independent principal components (PCs) were extracted. PC1 was the component of bonematerial quality. PC2 included height, weight, HD, and ND. PC3 mainly represented OFF. Multivariate linear regression showed that the PCs were strongly predictive of the FEA-predicted strength. This study provided quantitative information regarding the contributing factors of proximal femur strength and showed that such a biomechanical approach may have clinical potential in noninvasive assessment of hip fracture risk.
Original languageEnglish
Pages (from-to)1575-1585
Number of pages11
JournalAnnals of Biomedical Engineering
Issue number7
Publication statusPublished - 1 Jul 2012


  • Geometric morphology
  • Material distribution
  • Nonlinear finite element analysis
  • Proximal femur
  • Strength

ASJC Scopus subject areas

  • Biomedical Engineering


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