Grant: Project Grant

Hip fractures resulting from osteoporotic bone have a devastating impact as over a quarter of men and women die within a year of sustaining such an injury. For those who survive, quality of life is significantly reduced. With this in mind, a fracture liaison service (FLS) was recently established in Alberta that focuses on identifying hip fracture patients so that clinical management and health outcomes are vastly improved. Our research will build on the FLS program by addressing novel methods for assessing bone strength that move beyond traditional measures of bone mineral density, and leverage our base knowledge of normal human bone 3D microarchitecture. Our state-of-the-art approach to human bone imaging is based on high-resolution peripheral quantitative computed tomography. We are international leaders in establishing the role of human bone microarchitecture on bone strength that are tailored to each patient using techniques we developed. We will explore the 3D bone microarchitectural features that underpin bone fragility, by comparing hip fracture patients with healthy individuals from our CIHR-funded normative cohort. Using this knowledge, we will develop a novel approach that is implemented and tested as part of the FLS program to identify people at risk for hip fracture. This project is unique because it focuses specifically on a vulnerable hip fracture cohort from the Alberta FLS, which provides an exceptional opportunity to make an important leap towards a better screening tool to prevent fragility fractures. Our three aims are designed to establish the hallmarks of bone microarchitecture that are associated with hip fracture, and take a crucial step towards demonstrating the importance of incorporating 3D bone structure into the assessment of bone health and prevention of fractures. Our work will ultimately reduce the impact of fractures on our health care system.