{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T19:43:07Z","timestamp":1773949387565,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T00:00:00Z","timestamp":1641340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>While fractures of the distal femur are often considered as fragility fractures, detailed knowledge of the bone microarchitecture at this skeletal site is largely unavailable. Initial evaluation of a patient cohort with distal femur fractures showed a markedly increased occurrence in elderly women. The purpose of this study was to determine the extent to which demographic characteristics of distal femur fractures are reflected by general age\u2010 and sex\u2010specific variations in local microarchitectural parameters. Fifty cadaveric femora were collected from 25 subjects (12 females, 13 males, age 25\u201397\u2009years). A volume of interest within 3\u2009cm proximal to the condyles was analyzed using high\u2010resolution peripheral quantitative computed tomography (HR\u2010pQCT), which revealed impaired trabecular and cortical bone microarchitecture in women compared to men as well as in osteoporotic compared to normal or osteopenic subjects, as classified by dual\u2010energy X\u2010ray absorptiometry (DXA) T\u2010score. Linear regression analyzes showed negative associations between age and HR\u2010pQCT parameters in women (e.g., cortical thickness \u221214\u2009\u00b5m\/year, 95% CI: \u221221 to \u22127\u2009\u00b5m\/year), but not in men (e.g., cortical thickness 1\u2009\u00b5m\/year, 95% CI: \u221212 to 14\u2009\u00b5m\/year). HR\u2010pQCT parameters showed strong positive associations with areal bone mineral density (aBMD) determined by DXA at the hip in both sexes. Taken together, our findings suggest that female sex, advanced age, and low aBMD represent major risk factors for impaired microarchitecture at the distal femur. Both the diagnostic value of DXA for predicting distal femur fractures and the efficacy of bone\u2010specific agents on fracture risk reduction should be investigated in the future.<\/jats:p>","DOI":"10.1002\/jor.25246","type":"journal-article","created":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T10:30:31Z","timestamp":1641378631000},"page":"2057-2064","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Investigation of distal femur microarchitecture and factors influencing its deterioration: An ex vivo high\u2010resolution peripheral quantitative computed tomography study"],"prefix":"10.1002","volume":"40","author":[{"given":"Constantin","family":"Schmidt","sequence":"first","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery, Division of Orthopaedics University Medical Center Hamburg\u2010Eppendorf Hamburg 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