PURPOSE: Lunate collapse in older adult women has been sporadically reported as a condition distinct from classical Kienböck disease, which is typically observed in young men, and may represent fragility fractures associated with osteoporosis. Nonetheless, age-related differences in lunate bone density and mechanical properties have not been quantitatively assessed owing to the bone's small and complex anatomy.
METHODS: We conducted an exploratory cross-sectional study of 21 young women (20-29 years) and 57 older adult women (≥65 years). Using quantitative computed tomography with finite element analysis, we measured volumetric bone mineral density (vBMD) in the cortical, subchondral, and trabecular regions and estimated predicted bone strength. Between-group and within-group comparisons were performed, and correlations with age were assessed.
RESULTS: Older adult women demonstrated lower vBMD and predicted bone strength values than young women in both wrists, except for cortical vBMD. In young women, vBMD in all regions and predicted bone strength were higher in the dominant wrists. Age showed the strongest negative correlation with vBMD and predicted bone strength in the trabecular and subchondral regions.
CONCLUSIONS: This exploratory study demonstrates the feasibility of applying quantitative computed tomography with finite element analysis to the lunate and provides preliminary quantitative evidence of age-related bone deterioration. The pronounced decline in subchondral and trabecular bone suggests that lunate collapse in older women may share features with subchondral insufficiency fractures. Therefore, quantitative computed tomography with finite element analysis may be a promising tool for investigating small, anatomically complex bones and for establishing a methodological basis for future cadaveric validation and clinical studies.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic III.
Read the article: PubMed · Publisher (DOI)