Finite Element-Based Mechanical Assessment of Bone Quality on the Basis of In Vivo Images

Dieter H. Pahr, Philippe K. Zysset*

*Corresponding author for this work

Research output: Journal article (peer-reviewed)Review article

28 Citations (Scopus)


Beyond bone mineral density (BMD), bone quality designates the mechanical integrity of bone tissue. In vivo images based on X-ray attenuation, such as CT reconstructions, provide size, shape, and local BMD distribution and may be exploited as input for finite element analysis (FEA) to assess bone fragility. Further key input parameters of FEA are the material properties of bone tissue. This review discusses the main determinants of bone mechanical properties and emphasizes the added value, as well as the important assumptions underlying finite element analysis. Bone tissue is a sophisticated, multiscale composite material that undergoes remodeling but exhibits a rather narrow band of tissue mineralization. Mechanically, bone tissue behaves elastically under physiologic loads and yields by cracking beyond critical strain levels. Through adequate cell-orchestrated modeling, trabecular bone tunes its mechanical properties by volume fraction and fabric. With proper calibration, these mechanical properties may be incorporated in quantitative CT-based finite element analysis that has been validated extensively with ex vivo experiments and has been applied increasingly in clinical trials to assess treatment efficacy against osteoporosis.

Original languageEnglish
Pages (from-to)374-385
Number of pages12
JournalCurrent Osteoporosis Reports
Issue number6
Publication statusPublished - 01 Dec 2016
Externally publishedYes


  • Bone mineral density
  • Bone strength
  • Finite element analysis
  • Quantitative computed tomography
  • Trabecular bone

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism


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