In the human femoral neck, the contribution of the cortical and trabecular architecture to mechanical strength is known to depend on the load direction. In this work, we investigate if QCT-derived homogenized voxel finite element (hvFE) simulations of varying hip loading conditions can be used to study the architecture of the femoral neck. The strength of 19 pairs of human femora was measured ex vivo using nonlinear hvFE models derived from high-resolution peripheral QCT scans (voxel size: 30.3 µm). Standing and side-backwards falling loads were modeled. Quasi-static mechanical tests were performed on 20 bones for comparison. Associations of femur strength with volumetric bone mineral density (vBMD) or microstructural parameters of the femoral neck obtained from high-resolution QCT were compared between mechanical tests and simulations and between standing and falling loads. Proximal femur strength predictions by hvFE models were positively associated with the vBMD of the femoral neck (R² > 0.61, p < 0.001), as well as with its cortical thickness (R² > 0.27, p < 0.001), trabecular bone volume fraction (R² = 0.42, p < 0.001) and with the first two principal components of the femoral neck architecture (R² > 0.38, p < 0.001). Associations between femur strength and femoral neck microarchitecture were stronger for one-legged standing than for side-backwards falling. For both loading directions, associations between structural parameters and femur strength from hvFE models were in good agreement with those from mechanical tests. This suggests that hvFE models can reflect the load-direction-specific contribution of the femoral neck microarchitecture to femur strength.

中文翻译：

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非线性均质体素有限元模型对股骨强度的预测反映了股骨颈的微结构。

在人的股骨颈中，已知皮质和小梁结构对机械强度的贡献取决于载荷方向。在这项工作中，我们调查是否可以使用QCT派生的均质体素有限元（hvFE）模拟来模拟不同的髋部负荷条件，以研究股骨颈的结构。使用源自高分辨率外周QCT扫描（体素尺寸：30.3 µm）的非线性hvFE模型，离体测量19对人股骨的强度。对站立和侧向下落的载荷进行了建模。为了比较，对20块骨头进行了准静态力学测试。在力学测试和模拟之间以及在站立和下降载荷之间，比较了从高分辨率QCT获得的股骨强度与体积骨矿物质密度（vBMD）或股骨颈微结构参数之间的关系。hvFE模型预测的股骨近端强度与股骨颈的vBMD（R²> 0.61，p <0.001）以及其皮质厚度（R²> 0.27，p <0.001），小梁骨体积分数（R²）正相关= 0.42，p <0.001），股骨颈结构的前两个主要成分（R 2> 0.38，p <0.001）。单腿站立时股骨强度与股骨颈微结构之间的关联要强于侧向倒下。对于两个加载方向，hvFE模型的结构参数和股骨强度之间的关联与力学测试的关联良好。这表明hvFE模型可以反映股骨颈微结构对股骨强度的负荷方向特定贡献。