Application of a model based on dual-energy X-ray absorptiometry and finite element simulation for predicting the probability of osteoporotic hip fractures to a sample of people over 60 years

The aim of this work is the application of a mechanical predictive model to a sample of people over 60 years of age, in order to analyze the fracture probability related to age and sex. A total of 223 elderly people (63 men, aged 63–88, 72.32±6.10; 157 women, aged 61–89, 73.28±5.73) participated in the study. A dual-energy X-ray absorptiometry scanner was used to measure the bone mineral content and bone mineral density at total hip and femoral neck. The application of the predictive model also required a finite element simulation of the proximal femur, obtaining the mechanical damage and fracture probability maps corresponding to each sex and age groups analyzed. Statistical analysis shows higher values of bone mineral density, and consequently of Young’s modulus, for men than for women. In general, a decrease of BMD is observed since 65 years old. The maximum mechanical damage value is always located at the femoral neck. The results indicate that mechanical damage tends to increase with age. Coherently with mechanical damage, the maximum fracture probability value is always located at the femoral neck and tends to increase with age. The simulation model to determine the probability of fracture is more complete than the simple measurement of bone mineral density, because provides additional information about mechanical properties of bone, and allows for a prospective detection of fracture risk. The model may be used for risk evaluation in specific patients, if anatomical and dual-energy X-ray absorptiometry measurements are available, helping us to decide about preventive pharmacological treatment for hip fracture.