The relationship between whole bone stiffness and strength is age and sex dependent

Accurately estimating whole bone strength is critical for identifying individuals that may benefit from prophylactic treatments aimed at reducing fracture risk. Strength is often estimated from stiffness, but it is not known whether the relationship between stiffness and strength varies with age and sex. Cadaveric proximal femurs (44 Male: 18–78 years; 40 Female: 24–95 years) and radial (36 Male: 18–89 years; 19 Female: 24–95 years) and femoral diaphyses (34 Male: 18–89 years; 19 Female: 24–95 years) were loaded to failure to evaluate how the stiffness-strength relationship varies with age and sex. Strength correlated significantly with stiffness at all sites and for both sexes, as expected. However, females exhibited significantly less strength for the proximal femur (58% difference, p