Department of Civil and Environmental Engineering, Structural Biomechanics, Imperial College London, London, United Kingdom.
The Royal British Legion Centre for Blast Injury Studies, Imperial College London, London, United Kingdom.
PLoS One. 2024 Apr 29;19(4):e0297932. doi: 10.1371/journal.pone.0297932. eCollection 2024.
The incidence and morbidity of femoral fractures increases drastically with age. Femoral architecture and associated fracture risk are strongly influenced by loading during physical activities and it has been shown that the rate of loss of bone mineral density is significantly lower for active individuals than inactive. The objective of this work is to evaluate the impact of a cessation of some physical activities on elderly femoral structure and fracture behaviour. The authors previously established a biofidelic finite element model of the femur considered as a structure optimised to loading associated with daily activities. The same structural optimisation algorithm was used here to quantify the changes in bone architecture following cessation of stair climbing and sit-to-stand. Side fall fracture simulations were run on the adapted bone structures using a damage elasticity formulation. Total cortical and trabecular bone volume and failure load reduced in all cases of activity cessation. Bone loss distribution was strongly heterogeneous, with some locations even showing increased bone volume. This work suggests that maintaining the physical activities involved in the daily routine of a young healthy adult would help reduce the risk of femoral fracture in the elderly population by preventing bone loss.
股骨骨折的发病率和患病率随年龄增长而急剧增加。股骨结构和相关骨折风险受身体活动期间的负荷强烈影响，已有研究表明，与不活动者相比，积极活动者的骨密度流失率显著更低。本工作的目的是评估一些体力活动的停止对老年股骨结构和骨折行为的影响。作者之前建立了股骨的仿生有限元模型，该模型被视为一种针对与日常活动相关的负荷进行了结构优化的结构。此处使用相同的结构优化算法来量化停止爬楼梯和坐站后骨结构的变化。使用损伤弹性公式在适应的骨结构上运行侧方跌倒骨折模拟。在所有活动停止的情况下，总皮质骨和小梁骨体积以及失效载荷都减少了。骨量损失的分布存在很大的异质性，有些部位甚至显示出骨量增加。这项工作表明，通过防止骨丢失，保持年轻健康成年人日常活动中涉及的体力活动有助于降低老年人群股骨骨折的风险。
