Multiscale Geometric Methods for Isolating Exercise Induced Morphological Adaptations in the Proximal Femur

Abstract

The importance of skeletal bone in the functioning of the human body is well-established and acknowledged. Less pervasive among the populace, is the understanding of bone as an adaptive tissue which modulates itself to achieve the most construction sufficient for the role it is habituated to. These mechanisms are more pronounced in the long load bearing bones such as the femur. The proximal femur especially, functions under significant loads and does so with high degree of articulation, making it critical to mobility. Thus, exercising to buttress health and reinforce tissue quality is just as applicable to bone as it is to muscles. However, the efficiency of the adaptive (modelling/remodelling) processes is subdued after maturity, which makes the understanding of its potential even more important. Classically, studies have translated the evaluation of strength in terms of its material and morphology. While the morphology of the femur is constrained within a particular phenotype, minor variations can have a significant bearing on its capability to withstand loads. Morphology has been studied at different scales and dimensions wherein parameters quantified as lengths, areas, volumes and curvatures in two and three dimensions contribute towards characterising strength. The challenge has been to isolate the regions that show response to habitual loads. This thesis seeks to build on the principles of computational anatomy and develop procedures to study the distribution of mechanically relevant parameters. Methods are presented that increase the spatial resolution of traditional cross-sectional studies and develop a conformal mapping procedure for proximal femur shape matching. In addition, prevalent methods in cross-sectional analyses and finite element simulations are employed to analyse the morphology of the unique dataset. The results present the spatial heterogeneity and a multi-scale understanding of the adaptive response in the proximal femur morphology to habitual exercise loading

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