Investigation of repeatability in hip fracture risk predicted by DXA-based finite element model

DXA (dual energy X-ray absorptiometry) based finite element model is able to integrate all mechanical factors affecting hip fracture in osteoporosis patients and it is thus, in principle, more reliable than areal bone mineral density (BMD) for assessing fracture risk. However, short-term repeatability of DXA-based finite element model in predicting fracture risk has not yet been investigated and satisfactory repeatability is a prerequisite for the procedure to be applied in clinic. Therefore, in the reported research, the repeatability of a previously developed DXA-based patient-specific finite element procedure was investigated. It was found that inconsistence in positioning the patient during DXA scanning and manual segmentation of DXA image in constructing the finite element model are the two dominant factors affecting short-term repeatability of the finite element procedure. The study outcome indicated that to apply the finite element procedure in clinic, a set of more strict guidelines for positioning the patient in DXA scanning must be established and followed.