{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T15:21:46Z","timestamp":1791040906284,"version":"4.1.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2009,10,1]],"date-time":"2009-10-01T00:00:00Z","timestamp":1254355200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Monitoring of osteoporosis therapy based solely on DXA is insufficient to assess antifracture efficacy. Estimating bone strength as a variable closely linked to fracture risk is therefore of importance. Finite element (FE) analysis\u2013based strength measures were used to monitor a teriparatide therapy and the associated effects on whole bone and local fracture risk. In 44 postmenopausal women with established osteoporosis participating in the EUROFORS study, FE models based on high-resolution CT (HRCT) of T12 were evaluated after 0, 6, 12, and 24 mo of teriparatide treatment (20 \u03bcg\/d). FE-based strength and stiffness calculations for three different load cases (compression, bending, and combined compression and bending) were compared with volumetric BMD (vBMD) and apparent bone volume fraction (app. BV\/TV), as well as DXA-based areal BMD of the lumbar spine. Local damage of the bone tissue was also modeled. Highly significant improvements in all analyzed variables as early as 6 mo after starting teriparatide were found. After 24 mo, bone strength in compression was increased by 28.1 \u00b1 4.7% (SE), in bending by 28.3 \u00b1 4.9%, whereas app. BV\/TV was increased by 54.7 \u00b1 8.8%, vBMD by 19.1 \u00b1 4.0%, and areal BMD of L1\u2013L4 by 10.2 \u00b1 1.2%. When comparing standardized increases, FE changes were significantly larger than those of densitometry and not significantly different from app. BV\/TV. The size of regions at high risk for local failure was significantly reduced under teriparatide treatment. Treatment with teriparatide leads to bone strength increases for different loading conditions of close to 30%. FE is a suitable tool for monitoring bone anabolic treatment in groups or individual patients and offers additional information about local failure modes. FE variables showed a higher standardized response to changes than BMD measurements, but further studies are needed to show that the higher response represents a more accurate estimate of treatment-induced fracture risk reduction.<\/jats:p>","DOI":"10.1359\/jbmr.090416","type":"journal-article","created":{"date-parts":[[2009,5,6]],"date-time":"2009-05-06T18:11:23Z","timestamp":1241633483000},"page":"1672-1680","source":"Crossref","is-referenced-by-count":92,"title":["Improvements in Vertebral Body Strength Under Teriparatide Treatment Assessed In Vivo by Finite Element Analysis: Results From the EUROFORS Study"],"prefix":"10.1093","volume":"24","author":[{"given":"Christian","family":"Graeff","sequence":"first","affiliation":[{"name":"Medical Physics, Clinic of Diagnostic Radiology, University Clinic Schleswig-Holstein, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Chevalier","sequence":"additional","affiliation":[{"name":"Institute for Lightweight Design and Structural Biomechanics, TU Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Charlebois","sequence":"additional","affiliation":[{"name":"Institute for Lightweight Design and Structural Biomechanics, TU Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Varga","sequence":"additional","affiliation":[{"name":"Institute for Lightweight Design and Structural Biomechanics, TU Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dieter","family":"Pahr","sequence":"additional","affiliation":[{"name":"Institute for Lightweight Design and Structural Biomechanics, TU Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas N","family":"Nickelsen","sequence":"additional","affiliation":[{"name":"Lilly Deutschland, Bad Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M","family":"Morlock","sequence":"additional","affiliation":[{"name":"Institute for Biomechanics, TUHH Hamburg University of Technology, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus C","family":"Gl\u00fcer","sequence":"additional","affiliation":[{"name":"Medical Physics, Clinic of Diagnostic Radiology, University Clinic Schleswig-Holstein, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe K","family":"Zysset","sequence":"additional","affiliation":[{"name":"Institute for Lightweight Design and Structural Biomechanics, TU Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2009,12,4]]},"reference":[{"key":"2024020319555605300_bib1","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/S0002-9343(01)01124-X","article-title":"Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs","volume":"112","author":"Cummings","year":"2002","journal-title":"Am J Med"},{"key":"2024020319555605300_bib2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1359\/jbmr.2002.17.1.1","article-title":"Relationships between bone mineral density and incident vertebral fracture risk with raloxifene therapy","volume":"17","author":"Sarkar","year":"2002","journal-title":"J Bone Miner Res"},{"key":"2024020319555605300_bib3","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1359\/jbmr.060802","article-title":"Change in lumbar spine BMD and vertebral fracture risk reduction in teriparatide-treated postmenopausal women with osteoporosis","volume":"21","author":"Chen","year":"2006","journal-title":"J Bone Miner Res"},{"key":"2024020319555605300_bib4","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1615\/CritRevBiomedEng.v23.i5-6.20","article-title":"Finite element methods in spine biomechanics research","volume":"23","author":"Gilbertson","year":"1995","journal-title":"Crit Rev Biomed Eng"},{"key":"2024020319555605300_bib5","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/S8756-3282(03)00210-2","article-title":"Finite element models predict in vitro vertebral body compressive strength better than quantitative computed tomography","volume":"33","author":"Crawford","year":"2003","journal-title":"Bone"},{"key":"2024020319555605300_bib6","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1016\/S0021-9290(99)00099-8","article-title":"Femoral strength is better predicted by finite element models than QCT and DXA","volume":"32","author":"Cody","year":"1999","journal-title":"J Biomech"},{"key":"2024020319555605300_bib7","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1385\/JCD:7:2:153","article-title":"Image-based micro-finite-element modeling for improved distal radius strength diagnosis: Moving from bench to bedside","volume":"7","author":"Pistoia","year":"2004","journal-title":"J Clin Densitom"},{"key":"2024020319555605300_bib8","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1097\/BRS.0b013e31815e3993","article-title":"In vivo assessment of lumbar vertebral strength in elderly women using computed tomography-based nonlinear finite element model","volume":"33","author":"Imai","year":"2008","journal-title":"Spine"},{"key":"2024020319555605300_bib9","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1359\/jbmr.061011","article-title":"Effects of teriparatide and alendronate on vertebral strength as assessed by finite element modeling of QCT scans in women with osteoporosis","volume":"22","author":"Keaveny","year":"2007","journal-title":"J Bone Miner Res"},{"issue":"S1","key":"2024020319555605300_bib10","first-page":"S26","article-title":"Comparison of the effects of teriparatide and alendronate on parameters of total hip strength as assessed by finite element analysis: Results from the Forteo and Alendronate Comparison Trial","volume":"22","author":"Keaveny","year":"2007","journal-title":"J Bone Miner Res"},{"key":"2024020319555605300_bib11","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.bone.2003.12.001","article-title":"The osteoporotic vertebral structure is well adapted to the loads of daily life, but not to infrequent \u201cerror\u201d loads","volume":"34","author":"Homminga","year":"2004","journal-title":"Bone"},{"issue":"S1","key":"2024020319555605300_bib12","first-page":"S70","article-title":"Comparison of 3 Sequential Treatment Regimes of Teriparatide: Final Results from the EUROFORS study","volume":"21","author":"Eastell","year":"2006","journal-title":"J Bone Miner Res"},{"key":"2024020319555605300_bib13","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1359\/jbmr.070603","article-title":"Monitoring teriparatide-associated changes in vertebral microstructure by high-resolution CT in vivo: Results from the EUROFORS study","volume":"22","author":"Graeff","year":"2007","journal-title":"J Bone Miner Res"},{"key":"2024020319555605300_bib14","doi-asserted-by":"crossref","first-page":"3333","DOI":"10.1016\/j.jbiomech.2007.05.004","article-title":"Validation of a voxel-based FE method for prediction of the uniaxial apparent modulus of human trabecular bone using macroscopic mechanical tests and nanoindentation","volume":"40","author":"Chevalier","year":"2007","journal-title":"J Biomech"},{"key":"2024020319555605300_bib15","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s10237-008-0125-2","article-title":"A three-dimensional elastic plastic damage constitutive law for bone tissue","volume":"8","author":"Garcia","year":"2009","journal-title":"Biomech Model Mechanobiol"},{"key":"2024020319555605300_bib16","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1080\/10255840802078022","article-title":"A patient-specific finite element methodology to predict damage accumulation in vertebral bodies under axial compression, sagittal flexion and combined loads","volume":"11","author":"Chevalier","year":"2008","journal-title":"Comput Methods Biomech Biomed Engin"},{"key":"2024020319555605300_bib17","doi-asserted-by":"crossref","first-page":"1952","DOI":"10.1359\/jbmr.1999.14.11.1952","article-title":"Monitoring skeletal changes by radiological techniques","volume":"14","author":"Gluer","year":"1999","journal-title":"J Bone Miner Res"},{"key":"2024020319555605300_bib18","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1056\/NEJM200105103441904","article-title":"Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis","volume":"344","author":"Neer","year":"2001","journal-title":"N Engl J Med"},{"key":"2024020319555605300_bib19","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.1001\/archinte.165.15.1762","article-title":"Opposite bone remodeling effects of teriparatide and alendronate in increasing bone mass","volume":"165","author":"McClung","year":"2005","journal-title":"Arch Intern Med"},{"key":"2024020319555605300_bib20","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.bone.2006.01.147","article-title":"Time-lapsed investigation of three-dimensional failure and damage accumulation in trabecular bone using synchrotron light","volume":"39","author":"Thurner","year":"2006","journal-title":"Bone"},{"key":"2024020319555605300_bib21","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1016\/j.bone.2007.05.017","article-title":"Locations of bone tissue at high risk of initial failure during compressive loading of the human vertebral body","volume":"41","author":"Eswaran","year":"2007","journal-title":"Bone"},{"key":"2024020319555605300_bib22","doi-asserted-by":"crossref","first-page":"1885","DOI":"10.1359\/jbmr.070728","article-title":"Structural determinants of vertebral fracture risk","volume":"22","author":"Melton","year":"2007","journal-title":"J Bone Miner Res"}],"container-title":["Journal of Bone and Mineral Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1359%2Fjbmr.090416","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/24\/10\/1672\/56574828\/5650241007.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/24\/10\/1672\/56574828\/5650241007.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T14:52:43Z","timestamp":1710341563000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbmr\/article\/24\/10\/1672-1680\/7599879"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,10,1]]},"references-count":22,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2009,12,4]]},"published-print":{"date-parts":[[2009,10,1]]}},"URL":"https:\/\/doi.org\/10.1359\/jbmr.090416","relation":{},"ISSN":["0884-0431","1523-4681"],"issn-type":[{"value":"0884-0431","type":"print"},{"value":"1523-4681","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2009,10,1]]},"published":{"date-parts":[[2009,10,1]]}}}