Acta Mechanica Sinica

, Volume 31, Issue 2, pp 259–267 | Cite as

Tissue level microstructure and mechanical properties of the femoral head in the proximal femur of fracture patients

  • Linwei Lü
  • Guangwei Meng
  • He GongEmail author
  • Dong Zhu
  • Jiazi Gao
  • Yubo Fan
Research Paper


This study aims to investigate the regional variations of trabecular morphological parameters and mechanical parameters of the femoral head, as well as to determine the relationship between trabecular morphological and mechanical parameters. Seven femoral heads from patients with fractured proximal femur were scanned using a micro-CT system. Each femoral head was divided into 12 sub-regions according to the trabecular orientation. One \(125\,\hbox {mm}^{3}\) trabecular cubic model was reconstructed from each sub-region. A total of 81 trabecular models were reconstructed, except three destroyed sub-regions from two femoral heads during the surgery. Trabecular morphological parameters, i.e. trabecular separation (Tb.Sp), trabecular thickness (Tb.Th), specific bone surface (BS/BV), bone volume fraction (BV/TV), structural model index (SMI), and degree of anisotropy (DA) were measured. Micro-finite element analyses were performed for each cube to obtain the apparent Young’s modulus and tissue level von Mises stress distribution under 1 % compressive strain along three orthogonal directions, respectively. Results revealed significant regional variations in the morphological parameters (\(P < 0.05\)). Young’s moduli along the trabecular orientation were significantly higher than those along the other two directions. In general, trabecular mechanical properties in the medial region were lower than those in the lateral region. Trabecular mechanical parameters along the trabecular orientation were significantly correlated with BS/BV, BV/TV, Tb.Th, and DA. In this study, regional variations of microstructural features and mechanical properties in the femoral head of patients with proximal femur fracture were thoroughly investigated at the tissue level. The results of this study will help to elucidate the mechanism of femoral head fracture for reducing fracture risk and developing treatment strategies for the elderly.

Graphical Abstract

Bone blocks were reconstructed from micro-CT images of proximal femoral fracture patients. Apparent Young’s modulus and average stress of cancellous bone along three orthogonal directions were calculated by FEA. There were significant differences in mechanical properties between different regions and between different directions.


Femoral head Trabecular bone  Morphological parameters Micro-finite element analysis Apparent level  Tissue level 



This work is supported by the National Natural Science Foundation of China (Nos. 11322223, 11432016, 81471753 and 11272134), and the 973 Program (No. 2012CB821202).


  1. 1.
    Cong, A., Buijs, J.O., Dragomir-Daescu, D.: In situ parameter identification of optimal density-elastic modulus relationships in subject-specific finite element models of the proximal femur. Med. Eng. Phys. 33, 164–173 (2011)CrossRefGoogle Scholar
  2. 2.
    Gong, H., Zhang, M., Yeung, H.Y., et al.: Regional variations in microstructural properties of vertebral trabeculae with aging. J. Bone Miner. Metab. 23, 174–180 (2005)CrossRefGoogle Scholar
  3. 3.
    Judex, S., Boyd, S., Qin, Y.X., et al.: Combining high-resolution micro-computed tomography with material composition to define the quality of bone tissue. Curr. Osteoporos. Rep. 1, 11–19 (2003)CrossRefGoogle Scholar
  4. 4.
    Niebur, G.L., Feldstein, M.J., Yuen, J.C., et al.: High-resolution finite element models with tissue strength asymmetry accurately predict failure of trabecular bone. J. Biomech. 33, 1575–1583 (2000)CrossRefGoogle Scholar
  5. 5.
    Verhulp, E., Rietbergen, B., Huiskes, R.: Comparison of micro-level and continuum-level voxel models of the proximal femur. J. Biomech. 39, 2951–2957 (2006)CrossRefGoogle Scholar
  6. 6.
    Baum, T., Carballido-Gamio, J., Huber, M.B., et al.: Automated 3D trabecular bone structure analysis of the proximal femur-prediction of biomechanical strength by CT and DXA. Osteoporos. Int. 21, 1553–1564 (2010)CrossRefGoogle Scholar
  7. 7.
    Delaere, O., Dhem, A., Bourgois, R.: Cancellous bone and mechanical strength of the femoral neck. Arch. Orthop. Trauma Surg. 108, 72–75 (1989)CrossRefGoogle Scholar
  8. 8.
    Lai, Y.M., Qin, L., Yeung, H.Y., et al.: Regional differences in trabecular BMD and micro-architecture of weight-bearing bone under habitual gait loading—a pQCT and microCT study in human cadavers. Bone 37, 274–282 (2005)Google Scholar
  9. 9.
    Martens, M., Audekercke, R.V., Delport, P., et al.: The mechanical characteristics of cancellous bone at the upper femoral region. J. Biomech. 16, 971–983 (1983)CrossRefGoogle Scholar
  10. 10.
    Werner, C., Iversen, B.F., Therkildsen, M.H.: Contribution of the trabecular component to mechanical strength and bone mineral content of the femoral neck. An experimental study on cadaver bones. Scand. J. Clin. Lab. Invest. 48, 457–460 (1988)CrossRefGoogle Scholar
  11. 11.
    Krischak, G.D., Augat, P., Wachter, N.J., et al.: Predictive value of bone mineral density and Singh Index for the in vitro mechanical properties of cancellous bone in the femoral head. Clin. Biomech. 14, 346–351 (1999)CrossRefGoogle Scholar
  12. 12.
    Brenneman, S.K., Barrett-Connor, E., Sajjan, S., et al.: Impact of recent fracture on health-related quality of life in postmenopausal women. J. Bone Miner. Res. 21, 809–816 (2006)CrossRefGoogle Scholar
  13. 13.
    Gong, H., Zhang, M., Qin, L., et al.: Regional variations in the apparent and tissue-level mechanical parameters of vertebral trabecular bone with aging using micro-finite element analysis. Ann. Biomed. Eng. 35, 1622–1631 (2007)CrossRefGoogle Scholar
  14. 14.
    Nazarian, A., Muller, J., Zurakowski, D., et al.: Densitometric, morphometric and mechanical distributions in the human proximal femur. J. Biomech. 40, 2573–2579 (2007)CrossRefGoogle Scholar
  15. 15.
    Singh, M., Nagrath, A.R., Maini, P.S.: Changes in trabecular pattern of the upper end of the femur as an index of osteoporosis. J. Bone Jt. Surg. (Am) 52, 457–467 (1970)Google Scholar
  16. 16.
    Ulrich, D., Rietbergen, B., Laib, A., et al.: The ability of three-dimensional structural indices to reflect mechanical aspects of trabecular bone. Bone 25, 55–60 (1999)CrossRefGoogle Scholar
  17. 17.
    Bourne, B.C., Meulen, M.C.: Finite element models predict cancellous apparent modulus when tissue modulus is scaled from specimen CT-attenuation. J. Biomech. 37, 613–621 (2004)CrossRefGoogle Scholar
  18. 18.
    Harrison, N.M., McDonnell, P.F., O’Mahoney, D.C., et al.: Heterogeneous linear elastic trabecular bone modeling using micro-CT attenuation data and experimentally measured heterogeneous tissue properties. J. Biomech. 41, 2589–2596 (2008)CrossRefGoogle Scholar
  19. 19.
    Jaasma, M.J., Bayraktar, H.H., Niebur, G.L., et al.: Biomechanical effects of intraspecimen variations in tissue modulus for trabecular bone. J. Biomech. 35, 237–246 (2002)CrossRefGoogle Scholar
  20. 20.
    Linden, J.C., Birkenhager-Frenkel, D.H., Verhaar, J.A., et al.: Trabecular bone’s mechanical properties are affected by its non-uniform mineral distribution. J. Biomech. 34, 1573–1580 (2001)CrossRefGoogle Scholar
  21. 21.
    Djuric, M., Djonic, D., Milovanovic, P., et al.: Region-specific sex-dependent pattern of age-related changes of proximal femoral cancellous bone and its implications on differential bone fragility. Calcif. Tissue Int. 86, 192–201 (2010)CrossRefGoogle Scholar
  22. 22.
    Ascenzi, M.G., Hetzer, N., Lomovtsev, A., et al.: Variation of trabecular architecture in proximal femur of postmenopausal women. J. Biomech. 44, 248–256 (2011)Google Scholar
  23. 23.
    Cui, W.Q., Won, Y.Y., Baek, M.H., et al.: Age-and region-dependent changes in three-dimensional microstructural properties of proximal femoral trabeculae. Osteoporos. Int. 19, 1579–1587 (2008)CrossRefGoogle Scholar
  24. 24.
    Tanck, E., Bakker, A.D., Kregting, S., et al.: Predictive value of femoral head heterogeneity for fracture risk. Bone 44, 590–595 (2009)CrossRefGoogle Scholar
  25. 25.
    Yang, L., Burton, A.C., Bradburn, M., et al.: Distribution of bone density in the proximal femur and its association with hip fracture risk in older men: the MrOS study. J. Bone Miner. Res. 27, 2314–2324 (2012)CrossRefGoogle Scholar
  26. 26.
    Keyak, J.H., Rossi, S.A., Jones, K.A., et al.: Prediction of femoral fracture load using automated finite element modeling. J. Biomech. 31, 125–133 (1997)CrossRefGoogle Scholar
  27. 27.
    Morgan, E.F., Bayraktar, H.H., Keaveny, T.M.: Trabecular bone modulus-density relationships depend on anatomic site. J. Biomech. 36, 897–904 (2003)CrossRefGoogle Scholar
  28. 28.
    Snyder, S.M., Schneider, E.: Estimation of mechanical properties of cortical bone by computed tomography. J. Orthop. Res. 9, 422–431 (1991)CrossRefGoogle Scholar
  29. 29.
    Homminga, J., McCreadie, B.R., Ciarelli, T.E., et al.: Cancellous bone mechanical properties from normals and patients with hip fractures differ on the structural level, not on the bone hard tissue level. Bone 30, 759–764 (2002)CrossRefGoogle Scholar
  30. 30.
    Lochmuller, E.M., Matsuura, M., Bauer, J., et al.: Site-specific deterioration of trabecular bone architecture in men and women with advancing age. J. Bone Miner. Res. 23, 1964–1973 (2008)CrossRefGoogle Scholar
  31. 31.
    Mori, S., Harruff, R., Ambrosius, W., et al.: Trabecular bone volume and microdamage accumulation in the femoral heads of women with and without femoral neck fractures. Bone 21, 521–526 (1997)Google Scholar
  32. 32.
    El-Kaissi, S., Pasco, J.A., Henry, M.J., et al.: Femoral neck geometry and hip fracture risk: The Geelong osteoporosis study. Osteoporos. Int. 16, 1299–1303 (2005)Google Scholar
  33. 33.
    Gnudi, S., Ripamonti, C., Gualtieri, G., et al.: Geometry of proximal femur in the prediction of hip fracture in osteoporotic women. Br. J. Radiol. 72, 729–733 (1999)CrossRefGoogle Scholar

Copyright information

© The Chinese Society of Theoretical and Applied Mechanics; Institute of Mechanics, Chinese Academy of Sciences and Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Linwei Lü
    • 1
    • 2
  • Guangwei Meng
    • 2
  • He Gong
    • 2
    Email author
  • Dong Zhu
    • 3
  • Jiazi Gao
    • 2
  • Yubo Fan
    • 4
  1. 1.School of Mechanical EngineeringTianjin University of TechnologyTianjinChina
  2. 2.Department of Engineering MechanicsJilin UniversityChangchunChina
  3. 3.Department of Orthopaedic SurgeryNo. 1 Hospital of Jilin UniversityChangchunChina
  4. 4.Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical EngineeringBeihang UniversityBeijingChina

Personalised recommendations