In this thesis, a two-dimensional (2D) finite element (FE) model was developed from the patient’s hip DXA image to evaluate osteoporotic fracture risk. The loading configuration was designed to simulate a lateral fall onto the greater trochanter. Bone inhomogeneous mechanical properties (e.g. Young’s modulus) assigned to the FE model were correlated to bone mineral density captured in DXA image using empirical functions. In-house MATLAB codes were developed to investigate the effects of different factors such as bone mineral density, femoral neck length, neck diameter, neck angle and patient’s body weight on fracture risk. The 2D FE model constructed from DXA image was able to de-termine the factors which affect fracture risk to a greater extent based on the location of femur. The model developed here can be considered as a first attempt for investigating the effects of different parameters on fracture risk using patient specific 2D FE method.

In this thesis, a two-dimensional (2D) finite element (FE) model was developed from the patient’s hip DXA image to evaluate osteoporotic fracture risk. The loading configuration was designed to simulate a lateral fall onto the greater trochanter. Bone inhomogeneous mechanical properties (e.g. Young’s modulus) assigned to the FE model were correlated to bone mineral density captured in DXA image using empirical functions. In-house MATLAB codes were developed to investigate the effects of different factors such as bone mineral density, femoral neck length, neck diameter, neck angle and patient’s body weight on fracture risk. The 2D FE model constructed from DXA image was able to de-termine the factors which affect fracture risk to a greater extent based on the location of femur. The model developed here can be considered as a first attempt for investigating the effects of different parameters on fracture risk using patient specific 2D FE method.

Dual Energy X-ray Absorptiometry (DXA)-based finite element (FE) modelling has emerged as a potential tool for better assessment of osteoporotic hip fracture risk. Automation of this complex and computationally-intense procedure is the prime requirement for its clinical applicability. The aim of this study was to develop a fully automatic DXA-based finite element tool and assess its discrimination ability and short-term repeatability. The proximal femur was automatically segmented from clinical hip DXA scan and the subject-specific FE model was constructed for simulating sideways fall. Hip fracture risk indices (HFRIs) were calculated using two ways (along a femur cross-section and over a region of interest, ROI). Hip fracture discriminability increased when moved from femur cross-section based to ROI based HFRI calculation. A significant increase in hip fracture discriminability from baseline femoral neck and total hip bone mineral density (BMD) was achieved with ROI based HFRIs. Promising short-term repeatability was observed for HFRIs (coefficient of variation, CV, 3~3.5%). After removing representative poor cases, CVs were less than 3%. These preliminary results establish the potential of the proposed automatic tool for hip fracture risk assessment and justify large-scale clinical evaluation of its ability to predict incident hip fractures. / February 2017