基于有限元计算股骨近端骨折载荷和失效能量的新髋部骨折风险指数
A New Hip Fracture Risk Index Derived from FEA-Computed Proximal Femur Fracture Loads and Energies-to-Failure
摘要：
髋部骨折风险评估是一项重要但具有挑战性的任务。基于定量CT的患者特定有限元分析（FEA）计算特定载荷条件下股骨近端断裂的力（骨折载荷）。它提供了关于股骨近端的不同结构信息，这些信息可能会影响受试者的整体骨折风险。为了获得更可靠的断裂风险度量，我们使用主成分分析（PCA）开发了一个全球有限元分析计算的断裂风险指数，该指数将有限元分析计算的屈服和极限失效载荷以及四种载荷条件下的失效能量结合起来（单肢站立和跌倒后的冲击，后外侧，和大转子的外侧方面）的110例髋部骨折受试者和235名年龄和性别匹配的对照受试者从AGES-Reykjavik研究。我们发现FE参数的第一个PC（PC 1）是髋部骨折的唯一显著预测因子。使用逻辑回归模型，我们确定，如果预测性能的髋部骨折，使用PC 1不同，使用FE参数相结合的分层随机复位方面的髋部骨折的状态。结果表明，在男性受试者中，使用PC 1的接收工作特征曲线下面积（AUC）的平均值始终高于使用所有FE参数组合的AUC。合并的PC 1 AUC和FE参数AUC与女性受试者或所有受试者无显著差异
英文摘要：
Hip fracture risk assessment is an important but challenging task. Quantitative CT-based patient specific finite element analysis (FEA) computes the force (fracture load) to break the proximal femur in a particular loading condition. It provides different structural information about the proximal femur that can influence a subject overall fracture risk. To obtain a more robust measure of fracture risk, we used principal component analysis (PCA) to develop a global FEA computed fracture risk index that incorporates the FEA-computed yield and ultimate failure loads and energies to failure in four loading conditions (single-limb stance and impact from a fall onto the posterior, posterolateral, and lateral aspects of the greater trochanter) of 110 hip fracture subjects and 235 age and sex matched control subjects from the AGES-Reykjavik study. We found that the first PC (PC1) of the FE parameters was the only significant predictor of hip fracture. Using a logistic regression model, we determined if prediction performance for hip fracture using PC1 differed from that using FE parameters combined by stratified random resampling with respect to hip fracture status. The results showed that the average of the area under the receive operating characteristic curve (AUC) using PC1 was always higher than that using all FE parameters combined in the male subjects. The AUC of PC1 and AUC of the FE parameters combined were not significantly different than that in the female subjects or in all subjects
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