In:
Journal of Orthopaedic Research, Wiley, Vol. 25, No. 10 ( 2007-10), p. 1343-1350
Abstract:
Pathologic fracture is a significant problem for individuals with metastatic bone disease. Current guidelines for prophylactic internal fixation are neither reliable nor easily applied. The purpose of this study was to validate dual‐energy X‐ray absorptiometry (DXA) as an accurate method for estimating torsional bone strength of diaphyseal bone with endosteal lytic lesions. Endosteal lesions of varying sizes were simulated in the diaphyses of 12 adult cadaveric femurs. Unaltered contralateral femurs served as matched controls. Machined lesions ranged from 3 to 6.5 cm in length, 1 to 3 cm in width, 15 to 48 cm 2 in elliptical area, with 10% to 100% removal of the cortical thickness. Morphology and density data obtained from DXA images were used to estimate torsional strength. All femora were mechanically tested to failure in torsion. Physically measured torsional strength was not significantly correlated to lesion elliptical area ( r = 0.542, p 〉 0.05) or percentage cortical thickness removed ( r = 0.257, p 〉 0.05). Measured torsional strength was significantly correlated to DXA‐based torsional strength estimates ( r = 0.855, p 〈 0.01). Lesion size alone did not correlate with the strength of bones with simulated endosteal lytic lesions. In contrast, calculations based on DXA (morphology, density) did correlate with torsional strength. This is the first step in the development of a DXA‐based tool for objectively estimating bone strength in the presence of endosteal lytic lesions. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:1343–1350, 2007
Type of Medium:
Online Resource
ISSN:
0736-0266
,
1554-527X
Language:
English
Publisher:
Wiley
Publication Date:
2007
detail.hit.zdb_id:
2050452-4
