Bone最新文献

{"title":"Are balance and lower extremity muscle strength correlated with fracture risk independent of bone mineral density in postmenopausal women?: A cross-sectional study.","authors":"Büşra Şirin Ahısha, Nurdan Paker","doi":"10.1016/j.bone.2025.117414","DOIUrl":"https://doi.org/10.1016/j.bone.2025.117414","url":null,"abstract":"<p><strong>Background: </strong>Postmenopausal women are at increased risk of fractures due to reduced bone mineral density (BMD) and impaired physical function. While fracture risk assessment tools like FRAX include clinical factors and BMD, they exclude functional measures such as balance and muscle strength, which are critical for fall prevention. This study aimed to evaluate the correlation between two functional tests- the 30-Second Sit to Stand Test (30STS) and the One Leg Stance Test (OLST)- and fracture risk, independent of BMD in postmenopausal women aged 50-70.</p><p><strong>Methods: </strong>This cross-sectional study included 156 postmenopausal women aged 50-70. Fracture risk was assessed using FRAX. Postural balance was evaluated using the OLST, while lower extremity muscle strength was measured with the 30STS. Both tests were analyzed for correlations with 10-year risks of major osteoporotic fractures (MOF), hip fractures, femoral neck BMD, and T-score at the lumbar spine and femoral neck. Participants were grouped based on OLST (<10 s) and 30STS (<15 repetitions) cut-offs, and fracture risks were compared.</p><p><strong>Results: </strong>OLST and 30STS scores were significantly negatively correlated with 10-year hip fracture risk (r = -0.347, p < 0.001 and r = -0.197, p = 0.014, respectively). A significant negative correlation was also observed between OLST scores and 10-year MOF risk (r = -0.245, p = 0.002). Participants with OLST <10 s had significantly higher 10-year hip and MOF risks, while those with 30STS <15 had significantly higher 10-year hip fracture risk only. No correlation was found with femoral neck BMD.</p><p><strong>Conclusion: </strong>LST and 30STS are associated with fracture risk independent of BMD in postmenopausal women aged 50-70. These practical tests may help identify individuals at higher fracture risk and support early interventions.</p>","PeriodicalId":93913,"journal":{"name":"Bone","volume":" ","pages":"117414"},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The protection of nicotinamide riboside against diabetes mellitus-induced bone loss via OXPHOS.","authors":"Jie Gao, Xiangyuan Meng, Xingxiang Yang, Chenqi Xie, Chunyan Tian, Jianbao Gong, Junwei Zhang, Shiyou Dai, Tianlin Gao","doi":"10.1016/j.bone.2025.117411","DOIUrl":"10.1016/j.bone.2025.117411","url":null,"abstract":"<p><p>Diabetes mellitus is a global disease that results in various complications, including diabetic osteoporosis. Prior studies have indicated a correlation between low levels of nicotinamide adenine dinucleotide (NAD⁺) and diabetes-related complications. Nicotinamide riboside (NR), a widely utilized precursor vitamin of NAD⁺, has been demonstrated to enhance age-related osteoporosis through the Sirt1/FOXO/β-catenin pathway in osteoblast progenitors. However, the impact of NR on bone health in diabetes mellitus remains unclear. In this study, we assessed the potential effects of NR on bone in diabetic mice. NR was administered to high-fat diet (HFD)/streptozotocin (STZ)-induced type 2 diabetic mice (T2DM), and various parameters, including metabolic indicators, bone quality, bone metabolic markers, and RNA sequences, were measured. Our findings confirmed that HFD/STZ-induced T2DM impaired bone microstructures, resulting in bone loss. NR effectively ameliorated insulin resistance, improved bone microarchitecture, and bone quality, reduced bone resorption, enhanced the Forkhead box O (FOXO) signaling pathway, mitigated the nuclear factor kappa B (NF-kB) signaling pathway, and ameliorated the disorder of the oxidative phosphorylation process (OXPHOS) in diabetic mice. In conclusion, NR demonstrated the capacity to alleviate T2DM-induced bone loss through the modulation of OXPHOS in type 2 diabetic mice. Our results underscore the potential of NR as a therapeutic target for addressing T2DM-related bone metabolism and associated diseases. Further cell-based studies under diabetic conditions, such as in vitro cultures of key cell types (e.g., osteoblasts and osteoclasts), are necessary to validate these findings.</p>","PeriodicalId":93913,"journal":{"name":"Bone","volume":" ","pages":"117411"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type 2 diabetes patients exhibit delayed but coupled bone remodelling, maintaining cortical porosity comparable to healthy controls: A histomorphometric analysis of trans-iliac bone biopsies.","authors":"C M Andreasen, E M Wölfel, C Ejersted, T L Andersen, M Frost","doi":"10.1016/j.bone.2025.117412","DOIUrl":"10.1016/j.bone.2025.117412","url":null,"abstract":"<p><strong>Objective: </strong>Fracture risk is increased in longstanding type 2 diabetes (T2D). High-resolution peripheral quantitative CT scans have demonstrated higher cortical porosity in T2D complicated by microvascular disease (MVD). We investigated if cortical bone resorption is followed by inadequate bone formation in individuals with T2D complicated by MVD.</p><p><strong>Methods: </strong>Thirty-five adult men and women with T2D were recruited from outpatient clinics and through public advertisement. All participants had at least one previous measure of c-peptide >700, a negative GAD antibody test, and 13 had known microvascular disease status. Trans iliac crest bone biopsies were collected for histomorphometric analysis. Glucose control was assessed using HbA1c. Additionally, trans iliac bone specimens from 10 individuals without T2D were included as controls.</p><p><strong>Results: </strong>Following quality assessment, samples from 30 T2D and 10 controls were used for histomorphometric analyses of cortical bone remodelling. The final study population included 23 men and 7 postmenopausal women with a mean age of 65.8 years for the T2D-MVD group (CI95% 61.2-70.3) and 65.2 years in the T2D + MVD group (CI95% 59.6-70.9), and a mean T2D disease duration of 16.9 years. Seventeen had MVD (57 %). The controls included 5 men and 5 women with a mean age of 64.7 years (CI95% 58.5-70.9). The area, diameter, and density of cortical pores were the same in cases with and without MVD, but the pore diameter was lower than controls. While T2D had significantly more eroded-formative pores compared to controls, there were no significant differences in the proportion of eroded and formative pores between the groups. In quiescent pores/osteons, the osteon diameter and wall thickness were larger in T2D groups than controls.</p><p><strong>Conclusion: </strong>Cortical bone porosity was not increased in individuals with T2D complicated by MVD. However, an enhanced prevalence of eroded-formative pores and increased osteon diameter concur with a slightly prolonged reversal-resorption phase in T2D irrespective of the presence of MVD.</p>","PeriodicalId":93913,"journal":{"name":"Bone","volume":" ","pages":"117412"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Romosozumab and Raloxifene treatment targets impaired bone quality in a male murine model of diabetic kidney disease.","authors":"Rachel Kohler, Dyann M Segvich, Olivia Reul, Corinne E Metzger, Matthew R Allen, Joseph M Wallace","doi":"10.1016/j.bone.2025.117415","DOIUrl":"https://doi.org/10.1016/j.bone.2025.117415","url":null,"abstract":"<p><p>Comorbid diabetes and chronic kidney disease create a complex disease state with multi-faceted impacts on bone health, primarily reduced bone mass and tissue quality. To reduce fracture risk in this growing population, interventions are needed that target both bone mass and quality. Romosozumab (Romo) is an FDA-approved sclerostin inhibitor that has been shown to increase bone mass and strength in a murine model of combined diabetes and CKD (DKD), while Raloxifene (RAL) is a mild anti-resorptive used to treat osteoporosis that has also been shown to increase bone mechanical properties by increasing bone bound water content. We aimed to test whether combined RAL and Romo treatment could improve bone quality in our murine model of DKD more than either treatment alone. Using a previously established streptozotocin- and adenine-diet-induced model, male, C57BL/6J mice were randomly divided into four treatment groups and given daily subcutaneous injections of 100 μL vehicle (phosphorus buffered saline, PBS) or 0.5 mg/kg RAL. In addition, two groups were also given a weekly dose of Romo (10 mg/kg). Overall, Romo increased whole-bone strength and RAL improved tissue-level mechanical properties. Combined RAL-Romo treatment led to significantly higher cortical and trabecular bone mass compared to untreated controls. These morphological improvements created corresponding improvements in cortical bending strength and vertebral trabecular compression strength. These results suggest that combined RAL-Romo treatment provides both mass and quality improvements to DKD bone.</p>","PeriodicalId":93913,"journal":{"name":"Bone","volume":" ","pages":"117415"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cumulative exposure to triglyceride-glucose index and the risk of onset fragility fractures.","authors":"Wenchao Yao, Nan Zhang, Lu Guo, Xiaoli Hou, Shuohua Chen, Lei Xing, Xinhao Fan, Yajing Liang, Yixiu Chen, Zhihui Liu, Shouling Wu, Faming Tian","doi":"10.1016/j.bone.2025.117409","DOIUrl":"10.1016/j.bone.2025.117409","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between the cumulative exposure to triglyceride-glucose index (cumTyG index) and fragility fractures in the general population.</p><p><strong>Methods: </strong>This prospective cohort study analyzed active and retired employees of Kailuan Group who participated in three consecutive health examinations in 2006, 2008 and 2010, and were followed up until 31st December 2022. The cohort comprised 55,824 participants who met the inclusion and exclusion criteria and were grouped using the cumTyG index quartiles. The outcome event was onset fragility fracture. The cumulative incidence of fragility fracture in each group was calculated by the Kaplan-Meier method, and the incidence curve was plotted. Between-group comparisons were performed using the log-rank test. A Cox regression model was used to analyze the hazard ratio (HR) and 95 % confidence interval (CI) of fragility fractures.</p><p><strong>Results: </strong>Nine-hundred fragility fractures occurred during a mean follow-up of 11.35 years. After multivariate Cox regression analysis and adjustment for confounders (full model), the HR (95 % CI) of the group with the highest cumTyG index compared with the group with the lowest cumTyG index was 1.30 (1.04-1.61). The risk of fragility fracture was higher in men (HR 1.37, 95 % CI 1.06-1.77) and those taking antihypertensive drugs (HR 2.47, 95 % CI 1.25-4.86). There was a linear association between the cumTyG index and the risk of fragility fracture.</p><p><strong>Conclusion: </strong>A high cumTyG index is a risk factor for fragility fracture and should be considered in the management of patients with high blood sugar and high cholesterol concentrations.</p>","PeriodicalId":93913,"journal":{"name":"Bone","volume":" ","pages":"117409"},"PeriodicalIF":0.0,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological and non-pharmacological therapies for prevention and treatment of osteoporosis in Duchenne Muscular Dystrophy: A systematic review.","authors":"Sarah McCarrison, Shima Abdelrahman, Ros Quinlivan, Richard Keen, Sze Choong Wong","doi":"10.1016/j.bone.2025.117410","DOIUrl":"https://doi.org/10.1016/j.bone.2025.117410","url":null,"abstract":"<p><strong>Background: </strong>Long term glucocorticoid treatment in Duchenne Muscular Dystrophy (DMD) is associated with a high incidence of fragility fractures. This systematic review aims to assess the current evidence for pharmacological and non-pharmacological treatment for osteoporosis in children and adults with DMD.</p><p><strong>Methods: </strong>Three online databases (Embase, Medline, Cochrane Library) were searched for studies that evaluated interventions for treatment or prevention of osteoporosis in DMD. Included studies had to report changes in bone mineral density (BMD) or bone mineral content (BMC) Z-scores or fracture incidence.</p><p><strong>Results: </strong>Nineteen studies were identified, including twelve that evaluated bisphosphonate, three evaluated testosterone (2 studies of the same patient group), one evaluated vitamin D/calcium, one teriparatide, and two evaluated vibration therapy. Only two randomised-controlled trials were found, one of intravenous bisphosphonate and one of vibration therapy. Changes in lumbar spine BMD ranged from -0.3 to +1.3 in studies of bisphosphonate and - 0.2 to 0.0 with vibration therapy, whereas this was +0.38 with testosterone and + 0.9 with vitamin D/calcium. There was limited information on impact on fracture in all studies. None of the pharmacological studies involved a fracture naïve group at baseline. In addition, none addressed a group of individuals over 18 years at baseline.</p><p><strong>Conclusion: </strong>This systematic review provides evidence for the effectiveness of bisphosphonate therapy in improving bone density in children and adolescents with DMD. However, there is less information on the impact on fracture. The review did not find studies exclusively in those over 18 years old with DMD and limited information on non-bisphosphonate pharmacological agents.</p>","PeriodicalId":93913,"journal":{"name":"Bone","volume":"193 ","pages":"117410"},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of the serum 25-hydroxyvitamin D with mortality among patients in osteopenia or osteoporosis.","authors":"Ming Ma, Yuji Zhang, Jinmin Liu, Cong Tian, Zhenkun Duan, Xingchun Huang, Bin Geng","doi":"10.1016/j.bone.2025.117408","DOIUrl":"https://doi.org/10.1016/j.bone.2025.117408","url":null,"abstract":"<p><strong>Purpose: </strong>The correlation between serum vitamin D and mortality in patients with osteopenia or osteoporosis remains unclear. Therefore, this study examined the relationship between serum 25-hydroxy vitamin D [(25(OH)D] and mortality in patients with osteopenia or osteoporosis.</p><p><strong>Methods and result: </strong>This prospective cohort study included patients with osteopenia or osteoporosis from the National Health and Nutrition Examination Survey from 2001 to 2018. Multivariate Cox regression models examined the correlation between serum 25(OH) D and all-cause mortality, cardiovascular mortality (CVD), and cancer mortality. The cohort included 9282 adult participants with a median follow-up period of 97.01 months, including 1394 all-cause deaths, 413 CVD-related deaths, and 322 cancer deaths. In fully adjusted models, higher serum 25(OH) D levels (≥75.0 nmol/L) were associated with a lower risk of all-cause mortality (hazard ratio 0.54, 95 % confidence interval 0.41 to 0.73) and cardiovascular death (0.47, 0.29 to 0.76), using participants with low 25(OH) D levels (<25 nmol/L) as the reference. In addition, we found an L-shaped non-linear dose-response relationship between serum 25(OH) D and all-cause and cardiovascular mortality, with inflection points of 38.8 nmol/L and 53.6 nmol/L, respectively.</p><p><strong>Conclusion: </strong>Higher serum 25(OH) D concentrations are strongly associated with a diminished risk of all-cause and CVD mortality in patients with osteopenia or osteoporosis, this association has a threshold effect. More in-depth intervention studies are needed to clarify underlying mechanisms.</p>","PeriodicalId":93913,"journal":{"name":"Bone","volume":" ","pages":"117408"},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parathyroid hormone levels following denosumab vs. zoledronic acid therapy for osteoporosis.","authors":"Pnina Rotman-Pikielny, Liat Barzilai-Yosef, Erez Ramaty, Sofia Braginski-Shapira, Michal Kasher Meron, Tzipi Hornik Lurie","doi":"10.1016/j.bone.2025.117407","DOIUrl":"10.1016/j.bone.2025.117407","url":null,"abstract":"<p><p>The objective of this retrospective, database study was to characterize the rate, magnitude and timeline of increases in parathyroid hormone (PTH) levels post-denosumab (DMAb) vs. zoledronic acid (ZA) injection in patients with osteoporosis and near normal baseline PTH. Included were osteoporotic females, ≥50 years, initiating treatment with 60 mg DMAb or 5 mg ZA. PTH levels within 6-months post-DMAb or 12-months post-ZA injection were extracted from the electronic database of a 4.5 million-member health maintenance organization. The indication for PTH measurements was unknown. Exclusion criteria were creatinine >2 mg/dL, vitamin D < 50 nmol/L or parathyroid hormone level > 1.5 × upper limit of normal (ULN). Among 3317 women, 1992 received DMAb and 1325 ZA. The DMAb group was older (73.3 ± 8.5 vs. 69.8 ± 8.6 years, p < 0.001) and more patients treated with DMAb compared with patients treated with ZA had prior non-vertebral fractures (7.7 % vs. 5.2 %, p < 0.01) and had previously been treated with osteoporosis medication (56.3 % vs. 50.3 %, p < 0.001). Among the patients, 14.9 % had at least one post-treatment PTH > 1.5 ULN. Of 7273 post-treatment PTH tests, 62.6 % were within normal limits, while 24.8 % were mildly elevated at 1.01-1.5 ULN. Two-months after both treatments, >1.5 ULN PTH levels peaked at ∼20 %. Elevated PTH was associated with eGFR < 60 mL/min/1.73 m² and comorbidities. In conclusion, most PTH levels post-DMAb or ZA in osteoporotic patients with baseline PTH < 1.5 ULN, were within normal range. PTH increased to >1.5 ULN in 14.9 % of patients; peaking in the first 2-months post-treatment and declining thereafter. Elevated PTH may be related to anti-resorptive effects and is not medication specific. PTH measurements in the first few months post-DMAb and ZA therapy should be limited.</p>","PeriodicalId":93913,"journal":{"name":"Bone","volume":" ","pages":"117407"},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automatic segmentation of cortical bone microstructure: Application and analysis of three proximal femur sites.","authors":"Mathieu Simon, Silvia Owusu, Stefan Bracher, Dieter D Bosshardt, Michael Pretterklieber, Philippe Zysset","doi":"10.1016/j.bone.2025.117404","DOIUrl":"10.1016/j.bone.2025.117404","url":null,"abstract":"<p><p>Osteoporosis is the most common bone metabolic unbalance, leading to fragility fractures, which are known to be associated with structural changes in the bone. Cortical bone accounts for 80 % of the skeleton mass and undergoes remodeling throughout life, leading to changes in its thickness and microstructure. Although many studies quantified the different cortical bone structures using CT techniques (3D), they are often realised on a small number of samples. Therefore, the work presented here proposes a method to quantify cortical bone microstructure using 2D histology, shows its application on a set of 94 samples and compares to 3D methods. Fresh frozen human femur pairs from 47 donors aged between 57 and 96 years were obtained from the Medical University of Vienna. Bone samples were cut from 3 sites: proximal part of the diaphysis, inferior and superior segments of the neck. The samples were stained with toluidine blue and imaged under light microscopy. After manual segmentation of a few regions of interest by multiple operators, a convolutional neural network was trained in combination with a random forest for automatic segmentation. The segmentation analysis compares morphology and structure distribution of Haversian canals, osteocyte lacunae, and cement lines with literature, between anatomical sites, sex, left and right sides, and relation to ageing. Morphological analysis of the segmentation gives results similar to the literature. Comparison between male and female donors shows no significant differences. There is no significant difference between left and right femur on paired samples but significant differences are observed between anatomical locations. The structures' relative amounts do not present significant changes with age but only weak tendencies. Nevertheless, a strong correlation was observed between osteocyte lacunae density and bone areal fraction. This study presents a full process to stain and automatically segment digital cortical bone images. Its application to a large sample set of proximal femora provides strong statistics on the cortical bone structures morphology and distribution. Similarities observed between sides and sexes together with differences observed between sites could indicate that mechanical loading might be a main driver for bone microstructure. Additionally, the relationship between osteocyte lacunae density and bone areal fraction could suggest that bone porosity is regulated by osteocyte survival.</p>","PeriodicalId":93913,"journal":{"name":"Bone","volume":" ","pages":"117404"},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing HR-pQCT-based homogenised FE models with smooth structured hexahedral meshes.","authors":"Simone Poncioni, Kurt Lippuner, Philippe Zysset","doi":"10.1016/j.bone.2025.117394","DOIUrl":"https://doi.org/10.1016/j.bone.2025.117394","url":null,"abstract":"<p><p>Nonlinear homogenised finite element (hFE) models can accurately predict stiffness and strength of ultra-distal sections of the radius and tibia using in vivo HR-pQCT images. Recent findings showed good stiffness prediction at these distal sections but a limited ability to reproduce experimental strain localisation. The coarseness of voxel-based meshes reduces the computational effort at the cost of heavily simplifying the underlying geometry of the cortex, the gradient of material properties, and the resulting strain distribution. To overcome these limitations, we present a comprehensive approach to generating fully automated, smooth, and structured hexahedral meshes for HR-pQCT scans at the distal radius and tibia. This study used three datasets to validate the proposed hFE pipeline and its short-term repeatability: ex vivo 2nd generation HR-pQCT images of 21 human radii and 25 human tibiae, and 208 in vivo images from same-day repeated scans on 39 individuals. Results show high accuracy in predicting stiffness (tibia: R²=0.94, radius: R²=0.88) and yield force (tibia: R²=0.93, radius: R²=0.95). Mesh sensitivity analysis reveals stabilisation within a ± 3 % error margin. Dice similarity coefficients between mesh and scanned image were >0.99, and good element quality was achieved across the validation datasets (tibia: S-ICN_avg=0.809, radius: S-ICN_avg=0.764). Along with the improved volumetric representation of distal cortical and trabecular bone geometry and the good element quality, the new pipeline shows gains in computational performance: 11.70±1.49 min for triple-stack tibia images and 11.00±0.97 min for double-stack radius images, respectively. Generating structured meshes with consistent element-to-element correspondence facilitates seamless comparison between patient models or in longitudinal settings, providing an additional clinical information.</p>","PeriodicalId":93913,"journal":{"name":"Bone","volume":" ","pages":"117394"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}