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Long-term effects of bisphosphonate therapy: perforations, microcracks and mechanical properties

DOI: 10.1038/srep43399 DOI Help

Authors: Shaocheng Ma (Imperial College London) , En Lin Goh (Imperial College London) , Andi Jin (Imperial College London) , Rajarshi Bhattacharya (Imperial College London) , Oliver R. Boughton (Imperial College London) , Bhavi Patel (Imperial College London) , Angelo Karunaratne (University of Moratuwa) , Nghia T. Vo (Diamond Light Source) , Robert Atwood (Diamond Light Source) , Justin P. Cobb (Imperial College London) , Ulrich Hansen (Imperial College London) , Richard L. Abel (Imperial College London)
Co-authored by industrial partner: No

Type: Journal Paper
Journal: Scientific Reports , VOL 7

State: Published (Approved)
Published: March 2016
Diamond Proposal Number(s): 852 , 9811 , 11204 , 13337

Open Access Open Access

Abstract: Osteoporosis is characterised by trabecular bone loss resulting from increased osteoclast activation and unbalanced coupling between resorption and formation, which induces a thinning of trabeculae and trabecular perforations. Bisphosphonates are the frontline therapy for osteoporosis, which act by reducing bone remodelling, and are thought to prevent perforations and maintain microstructure. However, bisphosphonates may oversuppress remodelling resulting in accumulation of microcracks. This paper aims to investigate the effect of bisphosphonate treatment on microstructure and mechanical strength. Assessment of microdamage within the trabecular bone core was performed using synchrotron X-ray micro-CT linked to image analysis software. Bone from bisphosphonate-treated fracture patients exhibited fewer perforations but more numerous and larger microcracks than both fracture and non-fracture controls. Furthermore, bisphosphonate-treated bone demonstrated reduced tensile strength and Young’s Modulus. These findings suggest that bisphosphonate therapy is effective at reducing perforations but may also cause microcrack accumulation, leading to a loss of microstructural integrity and consequently, reduced mechanical strength.

Journal Keywords: 3-D reconstruction; Translational research; X-ray tomography

Subject Areas: Biology and Bio-materials, Medicine

Instruments: I12-JEEP: Joint Engineering, Environmental and Processing