Biomedical Engineering Reference
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observed in both women and men. Medullary expansion also occurs, typically at a
faster rate in women than men, resulting in net loss of cortical bone area in women,
but negligible loss in men. At metaphyseal sites there is also periosteal expansion
with endosteal expansion and net loss of cortical bone. But the most dramatic age-
related change at the metaphysis is loss of trabecular bone, which is observed in
women and men often at rates exceeding 10 %/decade. In some studies the rate of
trabecular bone loss is similar between the sexes, while in others women lose bone
at a faster rate than men. Data on the corresponding changes in whole-bone
mechanical properties with age are surprisingly few, especially for the diaphysis.
Increasingly, FEA is being used as surrogate for mechanical testing of the prox-
imal femur, distal radius and vertebra. Available data (mechanical and FEA)
indicate declines in bone strength with age that often correlate strongly with loss of
trabecular bone, especially at the distal radius and vertebra. Additional mechanical
data from large samples of bones covering 20-90 years would contribute greatly to
our understanding of the magnitude of strength loss with age, and how much of
this loss is explained by loss of cortical versus trabecular bone.
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