Active shape modeling of the hip in the prediction of incident hip fracture

Julie C. Baker-Lepain, Kali R. Luker, John A. Lynch, Neeta Parimi, Michael C. Nevitt, Nancy E Lane

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

The objective of this study was to evaluate right proximal femur shape as a risk factor for incident hip fracture using active shape modeling (ASM). A nested case-control study of white women 65 years of age and older enrolled in the Study of Osteoporotic Fractures (SOF) was performed. Subjects (n=168) were randomly selected from study participants who experienced hip fracture during the follow-up period (mean 8.3 years). Controls (n=231) had no fracture during follow-up. Subjects with baseline radiographic hip osteoarthritis were excluded. ASM of digitized right hip radiographs generated 10 independent modes of variation in proximal femur shape that together accounted for 95% of the variance in proximal femur shape. The association of ASM modes with incident hip fracture was analyzed by logistic regression. Together, the 10 ASM modes demonstrated good discrimination of incident hip fracture. In models controlling for age and body mass index (BMI), the area under receiver operating characteristic (AUROC) curve for hip shape was 0.813, 95% confidence interval (CI) 0.771-0.854 compared with models containing femoral neck bone mineral density (AUROC=0.675, 95% CI 0.620-0.730), intertrochanteric bone mineral density (AUROC=0.645, 95% CI 0.589-0.701), femoral neck length (AUROC=0.631, 95% CI 0.573-0.690), or femoral neck width (AUROC=0.633, 95% CI 0.574-0.691). The accuracy of fracture discrimination was improved by combining ASM modes with femoral neck bone mineral density (AUROC=0.835, 95% CI 0.795-0.875) or with intertrochanteric bone mineral density (AUROC=0.834, 95% CI 0.794-0.875). Hips with positive standard deviations of ASM mode 4 had the highest risk of incident hip fracture (odds ratio=2.48, 95% CI 1.68-3.31, p<.001). We conclude that variations in the relative size of the femoral head and neck are important determinants of incident hip fracture. The addition of hip shape to fracture-prediction tools may improve the risk assessment for osteoporotic hip fractures. © 2011 American Society for Bone and Mineral Research.

Original languageEnglish (US)
Pages (from-to)468-474
Number of pages7
JournalJournal of Bone and Mineral Research
Volume26
Issue number3
DOIs
StatePublished - Mar 2011

Fingerprint

Hip Fractures
Hip
ROC Curve
Confidence Intervals
Femur Neck
Bone Density
Femur
Osteoporotic Fractures
Hip Osteoarthritis
Case-Control Studies
Body Mass Index
Logistic Models
Odds Ratio

Keywords

  • Active shape modeling
  • bone
  • hip fracture
  • hip shape
  • osteoporosis

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Active shape modeling of the hip in the prediction of incident hip fracture. / Baker-Lepain, Julie C.; Luker, Kali R.; Lynch, John A.; Parimi, Neeta; Nevitt, Michael C.; Lane, Nancy E.

In: Journal of Bone and Mineral Research, Vol. 26, No. 3, 03.2011, p. 468-474.

Research output: Contribution to journalArticle

Baker-Lepain, JC, Luker, KR, Lynch, JA, Parimi, N, Nevitt, MC & Lane, NE 2011, 'Active shape modeling of the hip in the prediction of incident hip fracture', Journal of Bone and Mineral Research, vol. 26, no. 3, pp. 468-474. https://doi.org/10.1002/jbmr.254
Baker-Lepain, Julie C. ; Luker, Kali R. ; Lynch, John A. ; Parimi, Neeta ; Nevitt, Michael C. ; Lane, Nancy E. / Active shape modeling of the hip in the prediction of incident hip fracture. In: Journal of Bone and Mineral Research. 2011 ; Vol. 26, No. 3. pp. 468-474.
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