FE-Simulation in der klinischen Osteoporoseforschung: Möglichkeiten und Trends

Osteoporosis leads to higher bone fracture risk and is diagnosed by DXA. Unfortunately, DXA is not a perfect surrogate of bone strength and can often not explain the effect of pharmacological treatment. Currently a new methodology to determine bone strength becomes established: the Finite element method (FEM). This universal, widely accepted engineering method allows to diagnose bone fragility and the effect of treatment better than DXA and QCT. The CT-based FE models depend highly on image resolution. In this review, three types of models are presented (μCT, HR-pQCT, QCT) and the results of densitometric and FEM results are compared. In these cases, the FE results were always superior to densitometric ones. In addition, FE allows to determine a biomechanical fracture risk. Nevertheless, this advantage of FEM needs to be considered in the light of higher X-ray dose and service costs associated with CT imaging. In the future, FEM will be widely applied in the clinics, the question is only when and how.