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Construction of the Femoral Neck During Growth Determines its Strength in Old Age

Zebaze, Roger M D; Jones, Anthony; Knackstedt, Mark; Maalouf , Ghassan; Seeman, Ego

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Study of the design of the FN in vivo in 697 women and in vitro in 200 cross-sections of different sizes and shapes along each of 13 FN specimens revealed that strength in old age was largely achieved during growth by differences in the distribution rather than the amount of bone material in a given FN cross-section from individual to individual. Introduction: We studied the design of the femoral neck (FN) to gain insight into the structural basis of FN strength in adulthood and FN fragility in...[Show more]

dc.contributor.authorZebaze, Roger M D
dc.contributor.authorJones, Anthony
dc.contributor.authorKnackstedt, Mark
dc.contributor.authorMaalouf , Ghassan
dc.contributor.authorSeeman, Ego
dc.date.accessioned2015-12-07T22:55:27Z
dc.identifier.issn0884-0431
dc.identifier.urihttp://hdl.handle.net/1885/28388
dc.description.abstractStudy of the design of the FN in vivo in 697 women and in vitro in 200 cross-sections of different sizes and shapes along each of 13 FN specimens revealed that strength in old age was largely achieved during growth by differences in the distribution rather than the amount of bone material in a given FN cross-section from individual to individual. Introduction: We studied the design of the femoral neck (FN) to gain insight into the structural basis of FN strength in adulthood and FN fragility in old age. Materials and Methods: Studies in vivo were performed using densitometry in 697 women and in vitro using high-resolution μCT and direct measurements in 13 pairs of postmortem specimens. Results: The contradictory needs of strength for loading yet lightness for mobility were met by varying FN size, shape, spatial distribution, and proportions of its trabecular and cortical bone in a cross-section, not its mass. Wider and narrower FNs were constructed with similar amounts of bone material. Wider FNs were relatively lighter: a 1 SD higher FN volume had a 0.67 (95% CI, 0.61-0.72) SD lower volumetric BMD (vBMD). A 1 SD increment in height was achieved by increasing FN volume by 0.32 (95% CI, 0.25-0.39) SD with only 0.15 (95% CI, 0.08-0.22) SD more bone, so taller individuals had a relatively lighter FN (vBMD was 0.13 [95% CI, 0.05-0.20 SD] SD lower). Greater periosteal apposition constructing a wider FN was offset by even greater endocortical resorption so that the same net amount of bone was distributed as a thinner cortex further from the neutral axis, increasing resistance to bending and lowering vBMD. This was recapitulated at each point along the FN; varying absolute and relative degrees of periosteal apposition and endocortical resorption focally used the same amount of material to fashion an elliptical FN of mainly cortical bone near the femoral shaft to offset bending but a more circular FN of proportionally more trabecular and less cortical bone to accommodate compressive loads adjacent to the pelvis. This structural heterogeneity was largely achieved by adaptive modeling and remodeling during growth-most of the variance in FN volume, BMC, and vBMD was growth related. Conclusions: Altering structural design while minimizing mass achieves FN strength and lightness. Bone fragility may be the result of failure to adapt bone's architecture to loading, not just low bone mass.
dc.publisherAmerican Society for Bone and Mineral Research
dc.sourceJournal of Bone and Mineral Research
dc.subjectKeywords: adaptation; adult; aged; aging; article; bone bowing; bone densitometry; bone density; bone fragility; bone growth; bone mass; bone remodeling; bone strength; compressive strength; confidence interval; cortical bone; female; femur neck; femur shaft; human Architecture; External size; Femoral neck; Mineralized bone mass; Volumetric density
dc.titleConstruction of the Femoral Neck During Growth Determines its Strength in Old Age
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume22
dc.date.issued2007
local.identifier.absfor029902 - Complex Physical Systems
local.identifier.ariespublicationu9210271xPUB57
local.type.statusPublished Version
local.contributor.affiliationZebaze, Roger M D, University of Melbourne, Austin Hospital
local.contributor.affiliationJones, Anthony, College of Physical and Mathematical Sciences, ANU
local.contributor.affiliationKnackstedt, Mark, College of Physical and Mathematical Sciences, ANU
local.contributor.affiliationMaalouf , Ghassan, Babmand University Hospital
local.contributor.affiliationSeeman, Ego, University of Melbourne, Austin Hospital
local.description.embargo2037-12-31
local.bibliographicCitation.issue7
local.bibliographicCitation.startpage1055
local.bibliographicCitation.lastpage1061
local.identifier.doi10.1359/jbmr.070329
dc.date.updated2015-12-07T12:56:00Z
local.identifier.scopusID2-s2.0-34548585426
CollectionsANU Research Publications

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