Abstract
Osteoporosis is a prevalent bone condition, characterised by low bone mineral density and increased fracture risk. Currently, the gold standard for identifying osteoporosis and increased fracture risk is through quantification of bone mineral density using dual energy X-ray absorption. However, many studies have shown that bone strength, and consequently the probability of fracture, is a combination of both bone mass and bone ‘quality’ (architecture and material chemistry). Although the microarchitecture of both non-fracture and osteoporotic bone has been previously investigated, many of the osteoporotic studies are constrained by factors such as limited sample number, use of ovariectomised animal models, and lack of male and female discrimination. This study reports significant differences in bone quality with respect to the microarchitecture between fractured and non-fractured human femur specimens. Micro-computed tomography was utilised to investigate the microarchitecture of femoral head trabecular bone from a relatively large cohort of non-fracture and fracture human donors. Various microarchitectural parameters have been determined for both groups, providing an understanding of the differences between fracture and non -fracture material. The microarchitecture of non-fracture and fracture bone tissue is shown to be significantly different for many parameters. Differences between sexes also exist, suggesting differences in remodelling between males and females in the fracture group. The results from this study will, in the future, be applied to develop a fracture model which encompasses bone density, architecture and material chemical properties for both female and male tissues.
Highlights
Osteoporosis (OP) is a prevalent bone condition around the world, characterised by low bone mineral density and increased fracture risk
The use of bone mineral density (BMD) to diagnose osteoporosis is not without limitation, with a study by Wainwright reporting that 54% of new hip fractures occurred in women who did not have osteoporosis according to their BMD [5]
Using micro computed tomography (μ-CT), this study reports age-related microarchitectural changes in trabecular bone collected from the femoral head of 83 non-fracture individuals, within a wide age range of 20 – 93 years
Summary
Osteoporosis (OP) is a prevalent bone condition around the world, characterised by low bone mineral density and increased fracture risk. There have been a number of studies which investigate the change in trabecular microarchitecture with age using μ-CT [10,11,12,13] These studies tend to have large specimen numbers (n > 90) but do not consider bone which has fractured due to diseases such as osteoporosis or osteoarthritis. Using micro computed tomography (μ-CT), this study reports age-related microarchitectural changes in trabecular bone collected from the femoral head of 83 non-fracture individuals, within a wide age range of 20 – 93 years. We report the results of an aging study that enables a male/ female comparison, and a fracture/non-fracture comparison for both males and females This is one of the first studies of its kind to compare male and female specimens from both nonfracture and fracture tissue, in order to investigate the potential modelling and remodelling differences between sexes. The findings of this work are fundamental to the development of new diagnostic tests for osteoporosis, as they provide a bench mark for the microarchitectural parameters which should be considered when developing a fracture risk model
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