University of Oulu

Khakpour S, Esrafilian A, Tanska P, Mononen ME, Korhonen RK, Jämsä T (2022) Effect of osteoporosis-related reduction in the mechanical properties of bone on the acetabular fracture during a sideways fall: A parametric finite element approach. PLoS ONE 17(2): e0263458. https://doi.org/10.1371/journal.pone.0263458

Effect of osteoporosis-related reduction in the mechanical properties of bone on the acetabular fracture during a sideways fall : a parametric finite element approach

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Author: Khakpour, Shahab1; Esrafilian, Amir2; Tanska, Petri2;
Organizations: 1Research Unit of Medical Imaging, Physics, and Technology, University of Oulu, Oulu, Finland
2Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
3Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
4Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 5 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2022051736127
Language: English
Published: Public Library of Science, 2022
Publish Date: 2022-08-11
Description:

Abstract

Purpose: The incidence of acetabular fractures due to low-energy falls is increasing among the geriatric population. Studies have shown that several biomechanical factors such as body configuration, impact velocity, and trochanteric soft-tissue thickness contribute to the severity and type of acetabular fracture. The effect of reduction in apparent density and elastic modulus of bone as well as other bone mechanical properties due to osteoporosis on low-energy acetabular fractures has not been investigated.

Methods: The current comprehensive finite element study aimed to study the effect of reduction in bone mechanical properties (trabecular, cortical, and trabecular + cortical) on the risk and type of acetabular fracture. Also, the effect of reduction in the mechanical properties of bone on the load-transferring mechanism within the pelvic girdle was examined.

Results: We observed that while the reduction in the mechanical properties of trabecular bone considerably affects the severity and area of trabecular bone failure, reduction in mechanical properties of cortical bone moderately influences both cortical and trabecular bone failure. The results also indicated that by reducing bone mechanical properties, the type of acetabular fracture turns from elementary to associated, which requires a more extensive intervention and rehabilitation period. Finally, we observed that the cortical bone plays a substantial role in load transfer, and by increasing reduction in the mechanical properties of cortical bone, a greater share of load is transmitted toward the pubic symphysis.

Conclusions: This study increases our understanding of the effect of osteoporosis progression on the incidence of low-energy acetabular fractures. The osteoporosis-related reduction in the mechanical properties of cortical bone appears to affect both the cortical and trabecular bones. Also, during the extreme reduction in the mechanical properties of bone, the acetabular fracture type will be more complicated. Finally, during the final stages of osteoporosis (high reduction in mechanical properties of bone) a smaller share of impact load is transferred by impact-side hemipelvis to the sacrum, therefore, an osteoporotic pelvis might mitigate the risk of sacral fracture.

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Series: PLoS one
ISSN: 1932-6203
ISSN-E: 1932-6203
ISSN-L: 1932-6203
Volume: 17
Issue: 2
Article number: e0263458
DOI: 10.1371/journal.pone.0263458
OADOI: https://oadoi.org/10.1371/journal.pone.0263458
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Subjects:
Funding: Shahab Khakpour: This project received funding from European Union’s Horizon 2020 research and innovation programme under the Marie Skoldowska-Curie grant agreement No 713606. https://www.oulu.fi/i4future/ The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
EU Grant Number: (713606) I4FUTURE - Novel Imaging and Characterisation Methods in Bio, Medical, and Environmental Research and Technology Innovations
Copyright information: © 2022 Khakpour et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
  https://creativecommons.org/licenses/by/4.0/