Patient-Specific Finite Element Assessment of Femoral Fracture Risk in Osteogenesis Imperfecta: Influence of Homogeneous versus CT-based Material Modeling

Abstract

This study investigates how different material modeling approaches in finite element analysis (FEA) affect the prediction of femoral fracture risk in patients with osteogenesis imperfecta (OI). Patient-specific femur models were created from CT data and analyzed using two strategies: a homogeneous model with a constant Young's modulus and a heterogeneous, CT-based model with spatially varying material properties. The results show that homogeneous models consistently overestimate femoral strength, predicting failure loads 40–80% higher than CT-based models. In contrast, heterogeneous models reveal localized regions of weakness and higher strain concentrations, leading to more conservative and realistic fracture risk predictions. Overall, the study demonstrates that finite element fracture risk estimates are highly sensitive to material modeling assumptions.