Association between femur size and a focal defect of the superior femoral neck
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Gee, A., Treece, G., Tonkin, C., Black, D., & Poole, K. (2015). Association between femur size and a focal defect of the superior femoral neck. Bone, 81 60-66. https://doi.org/10.1016/j.bone.2015.06.024
Within each sex, there is an association between hip fracture risk and the size of the proximal femur, with larger femurs apparently more susceptible to fracture. Here, we investigate whether the thickness and density of the femoral cortex play a role in this association: might larger femurs harbour focal, cortical defects? To answer this question, we used cortical bone mapping to measure the distribution of cortical mass surface density (CMSD, mg/cm^2) in cohorts of 308 males and 125 females. Principal component analysis of the various femoral surfaces led to a measure of size that is linearly independent from shape. After mapping the data onto a canonical femur surface, we used statistical parametric mapping to identify any regions where CMSD depends on size, allowing for other confounding covariates including shape. Our principal finding was a focal patch on the superior femoral neck, where CMSD is reduced by around 1% for each 1% increase in proximal-distal size (p < 0:000005 in the males, p < 0:001 in the females). This finding appears to be consistent with models of functional adaptation, and may help with the design of interventional strategies for reducing fracture risk.
cortical bone mapping, osteoporotic fractures, hip structure analysis
KESP acknowledges the support of the NIHR Biomedical Research Centre, Cambridge, and funding from Arthritis Research UK (reference 20109). The MrOS study is supported by National Institutes of Health (NIH) funding. The following institutes provide support: the National Institute on Aging, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Center for Advancing Translational Sciences and the NIH Roadmap for Medical Research, under the following grant numbers: U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160 and UL1 TR000128.
Arthritis Research Uk (20109)
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
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External DOI: https://doi.org/10.1016/j.bone.2015.06.024
This record's URL: https://www.repository.cam.ac.uk/handle/1810/248838
Attribution-NonCommercial-NoDerivs 2.0 UK: England & Wales
Licence URL: http://creativecommons.org/licenses/by-nc-nd/2.0/uk/