A New Device to measure Whole and Tissue Level Bone Strength.

项目摘要/摘要 大多数骨折患者具有非骨质疏松性骨密度。通常情况下， 骨折是毁灭性的，并导致相当大的发病率和医疗费用。一个原因是 这些患者的脆性是骨骼质量差，从而导致更高的风险 骨折。然而，在临床上几乎没有可用的技术来准确评估骨骼质量。双人 能量x射线吸收测量法(DXA)是临床上最常用的骨折风险替代物，但 没有考虑到骨骼质量，因此高估了骨骼健康。OsteoProbe®支持 测量人类患者的骨质量，并已获得FDA批准。OsteoProbe® 将骨材料质量量化为一种测量方法，称为骨材料强度指数 胫骨通过快速微压入过程。一种重要的和高度可预测的关系 已证实胫骨BMSi与多个骨骼部位的骨折发生有关。BMSi 也被证明对股骨颈的骨强度有很强的预测性。正在进行的 SBIR第二阶段研究正在调查骨显像测量之间的关系 绝经后身体上这些临床相关骨骼部位的胫骨和骨强度。 我们假设，OsteoProbe®测量也将被证明对艾滋病毒患者也有价值 有较高的骨折风险，但骨密度不低。该建议旨在：(1)对比DEXA 和BMSI作为HIV+和HIV-人群之间的真实骨强度的预测因子 骨骼部位，以及(2)确定艾滋病毒骨骼的微观结构和组织水平的变化，即 与正常老龄化人群相比，OsteoProbe可检测到。我们 假设HIV+骨骼将在较低长度的鳞片上表现出不同的损伤 对BMSI的影响大于非HIV骨骼。

Project Summary/Abstract Most patients who fracture have non-osteoporotic bone mineral density. Often, the result of a fracture is devastating and results in substantial morbidity and health care costs. One cause of fragility in these patients is poor bone quality that subsequently contributes to higher risk for fracture. Yet few techniques are available to accurately assess bone quality in the clinic. Dual energy x-ray absorptiometry (DXA) is the most used clinical surrogate for fracture risk, but DXA does not account for bone quality and thus overestimates bone health. OsteoProbe® enables the measurement of bone quality in human patients and has been FDA cleared. The OsteoProbe® quantifies bone material quality as a measure termed bone material strength index (BMSi) at the tibia through a rapid microindentation process. A significant and highly predictive relationship has been demonstrated between tibial BMSi and fracture occurrence at multiple skeletal sites. BMSi has also been shown to be strongly predictive of bone strength at the femoral neck. The ongoing SBIR Phase II study is investigating the relationship between OsteoProbe measurements at the tibia and bone strength at these clinically relevant skeletal sites on post-menopausal cadavers. We hypothesize that OsteoProbe® measurements will also prove valuable for HIV patients who are at higher risk of fracture but do not have low BMD. The proposal aims to: (1) Contrast DEXA and BMSi as predictors of true bone strength between HIV+ and HIV- populations across multiple skeletal sites, and (2) Determine the microstructural and tissue-level changes in HIV bone that is detectable by the OsteoProbe, compared with those of the normal aging population. We hypothesize that HIV+ bones will exhibit impairments at lower length scales that differentially affects BMSi than non-HIV bones.