Grant: Project Grant - PA: MSK, Skin and Oral Health: Clinical Research - MSK Health

Hip fracture is a significant cause of morbidity and mortality; it happens easier in older people especially women. A question here is: what makes bone fragile as we become older? Current consensus is that our femoral bone becomes weaker and brittle because of the loss in bone mineral density, which is the combined result of increased porosity and decreased thickness in cortical shell. Although as equally important as those geometrical parameters, ageing-related changes in the structure and mechanical properties of bone at the material level are poorly understood. We have discovered in our pilot study that the femoral cortical bone in older people experiences abnormal changes both structurally and mechanically. There is a layer of highly mineralized tissue covering the surface of human femoral neck, which is extremely brittle. We hypothesized that the presence of this hypermineralized tissue directly increases hip fragility. In this project, an experienced bone biologist, a materials engineer with expertise in bone fracture, and a trauma surgeon team up to study the impact of the hypermineralized tissue on hip fragility fracture. By using various advanced microscopy techniques, we aimed to answer the following four questions: Why is this hypermineralized tissue so brittle? How is this tissue distributed in femoral bone? Are there any differences between men and women? What is its role in hip fragile fracture? Answers to these questions will advance our knowledge on bone biology and bone quality, help to develop new techniques of bone diagnoses, and lead to new measures of fracture prevention.