Osteoporosis causes bones to lose mass and become weak. However, for many sufferers, the first indication that they have the condition is when they actually sustain a fracture. While drugs can slow or arrest the development of the disease, they carry their own side effects, and the condition may already be quite ad vanced by the time the first break occurs.

Fig. 1 – A tiny probe can test the strength of a patient’s bones and could reveal early signs of osteoporosis. (Credit, Louise Coutts, University of Southampton)

Doctors can estimate an individual’s risk of fracturing by using bone-density measurements and other factors such as age, gender, smoking, and any history of fracturing.

Existing methods of assessing bone fragility measure bone density using Xrays. But a new technology, originally conceived of at the University of California, Santa Barbara, and currently being refined and tested at the University of Southampton in the UK, uses a tiny probe designed to test the strength of a patient’s bones and measure the ability of bone tissue to prevent small cracks growing into full-blown fractures.

This microindentation technology affordably delivers a fundamentally different measurement that has great potential to refine such an evaluation.

How It Works

The portable, handheld device presses a microscopic needle a short distance into the top layer of bone. Measured electronically, the amount of penetration indicates how fragile the bone tissue is and, therefore, the risk of experiencing an osteoporotic fracture later in life.

A normal reading might see the needle sink into the bone by around 20 micrometers (0.02 mm); a reading of 40 micrometers might indicate a significant risk of fracture.

“As the population ages and life expectancy rises in the decades ahead, the cost of treating osteoporotic fractures will increase,” says Professor Philipp Thurner at the University of Southampton, who is leading the project. “One in three women aged over 50 is forecast to experience an osteoporotic fracture in her lifetime and, globally, treatment costs are forecast to reach over US$130 billion by 2050. The potential improvement in assessing osteoporosis and future fracture risk offered by this new technology could reduce the burden of broken bones for individuals, healthcare systems, and the economy.”

Where It Stands

The investigators are inviting patients at Southampton General Hospital who have had a hip replacement due to a broken hip to take part in the Observational Study Examining Osteoporosis, which is investigating the device. So far, 23 patients have agreed to take part in the study.

While bone density scanning is the current “gold standard” diagnostic tool, it is not a perfect measure of bone strength and does not show the quality of bone, the researchers say. New techniques, which look at further measures of bone fragility, are important in developing researchers’ understanding of osteoporosis and bone health and in helping to reduce the number of fragility fractures.

The microindentation device to test the strength of a patient’s bones and diagnose early signs of osteoporosis could be available for clinical use within five years, the researchers say.

The three-year research project, “Handheld Microindentation – A Direct Assessment of Bone Fracture Risk,” is scheduled to run until 2015. Before it can enter widespread use, the technology will require further clinical development and testing in clinical trials.

University of Southampton, Southampton, UK http://www.southampton.ac.uk