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Comparison of Bone Mineral Parameter Measurements by Dual-Energy X-ray Absorptiometry With Bone Stiffness Measurements as Indicators of the Load-Bearing Capacity of Regenerating Bone

Floerkemeier, Thilo MD; Wellmann, Mathias MD; Thorey, Fritz MD; Hurschler, Christof PhD; Witte, Frank MD; Windhagen, Henning MD

Journal of Orthopaedic Trauma: March 2010 - Volume 24 - Issue 3 - p 181-187
doi: 10.1097/BOT.0b013e3181bae887
Original Article

Objectives: The objective of this study was to compare bone mineral density and content measurements by dual-energy x-ray absorptiometry with bone stiffness measurements as indicators of the load-bearing capacity of regenerating bone during distraction osteogenesis.

Methods: The study analyzed ex vivo a set of 26 sheep bone specimens after distraction osteogenesis. Bone mineral density and bone mineral content were measured by dual-energy x-ray absorptiometry. Biomechanical parameters such as torsional, compressive, and bending stiffness were determined using a material testing system. The maximum torsional moment applied at fracture is used to determine the load-bearing capacity of the bone.

Results: The correlation between stiffness measurements and the load-bearing capacity of a bone is significantly greater than the correlation between load-bearing capacity and bone mineral density and content measurements by dual-energy x-ray absorptiometry.

Conclusion: The results of this ex vivo study indicate that stiffness measurements are a better quantitative indicator of the load-bearing capacity of a bone and thus of bone healing than bone mineral density and content measurements by dual-energy x-ray absorptiometry. The results of the current study do not confirm previous work that showed that there is a significant correlation between bone material quality obtained by dual-energy x-ray absorptiometry and bone strength.

From the Department of Orthopaedic Surgery, Hannover Medical School, Hannover, Germany.

Accepted for publication July 14, 2009.

Fixator parts, used in this study, were a generous gift of Smith + Nephew, Hamburg, Germany. Parts of this study were supported by Wyeth, Cambridge, MA.

Reprints: Thilo Floerkemeier, MD, Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625 Hannover, Germany (e-mail: Thilo.Floerkemeier@annastift.de).

© 2010 Lippincott Williams & Wilkins, Inc.