QCT-based failure analysis of proximal femurs under various loading orientations.

In this paper, the variations of the failure strength and pattern of human proximal femur with loading orientation were analysed using a novel quantitative computed tomography (QCT)-based linear finite element (FE) method. The QCT images of 4 fresh-frozen femurs were directly converted into voxel-based finite element models for the analyses of the failure loads and patterns. A new geometrical reference system was used for the alignment of the mechanical loads on the femoral head. A new method was used for recognition and assortment of the high-risk elements using a strain energy-based measure. The FE results were validated with the experimental results of the same specimens and the results of similar case studies reported in the literature. The validated models were used for the computational investigation of the failure loads and patterns under 15 different loading conditions. A consistent variation of the failure loads and patterns was found for the 60 different analysed cases. Finally, it was shown that the proposed procedure can be used as a reliable tool for the failure analysis of proximal femurs, e.g. identification of the relevant loading directions for specific failure patterns, or determination of the loading conditions under which the proximal femurs are failure-prone.