Osteoporosis, currently diagnosed by measuring bone mineral density (BMD) using dual-energy X.-ray absorptiometry, is the most common metabolic bone disease in Europe. It results in highly increased fracture risk, which is not optimally predicted by BMD. Bisphosphonates are used for medical treatment of osteoporosis. They have an advantageous impact on bone microarchitecture, but long term treatment can lead to deterioration of bone structural integrity and increased fracture risk, despite high BMD. Several factors related to bone quality. i.e. bone architecture, geometry, turnover and mineralization and accumulation of microfractures contribute significantly to fracture risk. Development of new coherent methods for evaluating bone quality is necessary to improve diagnostics, and to monitor treatments and assessment of fracture risk. The aims are to 1) improve the understanding of bone quality in health and disease, 2) diagnose more effectively early osteoporosis and 3) predict more accurately fracture risk. Specifically, we assess the effects of aging, osteoporosis, and long term bisphosphonate treatment on structural, compositional and mechanical properties of trabecular bone from human cadavers. MicroCT is used to analyze trabecular microarchitecture and spatial BMD. Cellular events and bone remodeling processes are analyzed histomorphometrically. Microscopic and spectroscopic methods are used to study composition of organic and non-organic components. Also, novel backscattered ultrasound methods are used for trabecular bone diagnostics and to assess their feasibility for clinical practice. Interrelationships between bone characteristics will be addressed using statistical and modeling techniques. The techniques will provide quantitative information on bone quality, not previously possible. University of Kuopio provides excellent facilities to carry out this study, including well-known bone researchers (profs Jurvelin and Kröger), who will act as supervisors.
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