Osteoporosis is a major bone disease characterized by low bone mass and microarchitecture deterioration, which affects primarily trabecular sites and leads to increased bone fragility. Trabecular bone mechanical properties have direct relations with bone fragility. High-resolution image based-finite element (FE) models with the detailed 3D microstructure have been widely utilized to assess the mechanical properties of trabecular bone. Voxel-based FE model can be generated by converting individual voxels of high resolution bone images into 8-node brick elements. A number of studies have compared mechanical properties predicted by the voxel model with those by mechanical testing and have demonstrated that the voxel FE model can accurately predict the Young’s modulus and yield strength of human trabecular bone (1). However, the computational expense of the voxel-based technique, in general, limits its clinical applications, especially the nonlinear analysis for whole bone strength. Thus, it is not applicable to apply this technique to clinical use with the respect of current computer capability. There is apparent need for an alternative modeling approach that is more computationally efficient while preserving the accuracy of the predictions.

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