These are examples of current research projects at our lab, listed by the nicknames we use internally. These studies are funded by CIHR, NSERC, The Arthritis Society, the Canadian Space Agency, industry and foundations.
Predicting hip fracture (HIPFX)
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. Our research coordinates with the fracture liaison service (FLS) program in Calgary by using HR-pQCT to assess bone microarchitecture. In patients with a recent fracture, HR-pQCT captures 3D microarchitecture that might give us insight into who is susceptible to fractures. By comparing hip fracture patients with healthy individuals from our normative cohort we can identify phenotypes of bone architecture that might improve prediction of fractures and help guide who to treat and when. We recently developed a new morphological measurement based on abnormal architecture that is turning out to be a great predictor of fracture that is independent of bone mineral density. Our work on hip fractures has also extended to clinical CT and using techniques of ‘opportunistic CT’ to develop methods that would screen people for osteoporosis before any fractures occur. Our goal is to ultimately reduce the impact of fractures on our health care system. This study is funded by CIHR.
Post-traumatic knee injuries (SALTAC)
The role of subchondral bone in the knee following an acute injury is not well understood, yet there are significant changes in all the joint tissues that lead to a high likelihood of developing post-traumatic osteoarthritis (OA). Much of the focus has been on the degeneration of cartilage because cartilage wear is associated with disease severity, but our focus is on the bone. We know it changes fast after an injury, and through over a decade of work translating pre-clinical to clinical research, we are now able to use HR-pQCT to monitor in the finest detail what happens to bones in an injured joint. We couple those measurements with MR assessments of cartilage to get a whole picture of joint degeneration. We’re very interested in using this new knowledge to design interventions that can alter the course of a joint injury. Key to our approach is the advanced imaging technology we have developed to simultaneously measure bone and cartilage in injured patients over time. This work is funded by The Arthritis Society and CIHR.
Effect of high-dose vitamin D on bone (VITD)
The Calgary Vitamin D study is a 3-year randomized control trial (RCT) testing the effects of high-dose vitamin D supplementation (400 versus 4000 or 10000 IU daily) in vitamin-D sufficient men and women, with primary outcomes of bone mineral density and estimated bone strength. Measurements included second-generation HR-pQCT, DXA, finite element analysis, bone turnover markers, balance and more. Participants were healthy men and women between ages 55 and 70 years with DXA T-scores above -2.5 and serum 25OHD between 30 and 127 nmol/L. Participants consuming <1200 mg/day of dietary calcium received calcium supplementation. We have been exploring the dose-response effect of vitamin D supplementation and published some very interesting results. This study is funded by a health advocate foundation based in Calgary.
Non-invasive estimate of bone strength (BONE STRENGTH)
An ongoing programmatic theme is the establishment of non-invasive approaches to estimating bone strength. This research program has evolved over the years, but has maintained a focus on understanding mechanistic models of bone adaptation, techniques for high-throughput image processing, and multi-modal imaging for integrating biological tissues. It has led to the development of customized software for large-scale finite element analysis, automated image segmentation techniques and uses novel longitudinal HR-pQCT image data. These studies collectively help us understand how bones remodel under a variety of physiological and mechanical conditions. This research has been funded by NSERC through the Discovery Grant program.
Dual-energy CT for bone stress injuries (NAVICULAR)
Navicular stress fractures are a rare but career-threatening injury for athletes that often go undiagnosed. We started a study that utilizes dual-energy computed tomography (DECT) and HR-pQCT to assess these injuries and to compare them against the gold-standard approach MRI. The challenges of recruiting people for this study have been significant, and so we’ve expanded in scope to explore bone stress injuries in general, and to focus on the use of DECT for diagnosing these types of injuries. We are interested, for example, whether it’s possible to use DECT for detecting bone marrow lesions, an injury that can transiently occur at the knee after a ligament injury. Our goal is to develop diagnostic tools to inform management of stress fractures and related injuries so that they can be treated effectively. This study is funded by a partnership between GE and the NBA.
Effects of space flight on bone (TBONE)
One of the most potent stimuli for bone remodeling is mechanical unloading, and when astronauts go to the International Space Station (ISS) the micro-gravity environment can lead to significant bone loss, especially since they are there for months at a time. While bone loss in space is well known, we are exploring whether the microarchitectural changes that occur can be reversed when they return to Earth. This work will establish whether the time they spend on the ISS affects the magnitude of loss, and how much of the strength lost can be regained once returned back on Earth. Since 2014, we have a second HR-pQCT system located at NASA’s Johnson Space Center where we travel to regularly to measure crew member bones. The next phase of our project will study astronauts who spend a year on the ISS as part of an international integrated project designed to understand if travel to the Moon or Mars is safe. This study is funded by the Canadian Space Agency and you can learn about TBone here.
Population-based estimate of bone strength (CAMOS)
In 2005 we installed the first HR-pQCT scanner in Canada and among the first world-wide. This allowed us to see in vivo human bone microarchitecture for the first time and was an opportunity to team up with the Canadian Multicentre Osteoporosis Study, a national project to establish a population-based cohort for understanding metabolic bone disease. These data provided a basis for reference data so that we could compare HR-pQCT results to a normal population. It also addressed a number of aspects of bone development including how porosity changes during menopause in women, how men and women differ in microarchitecture, and whether there is a relationship between parity and bone microarchitecture. In 2013 we installed the first second-generation HR-pQCT in the world, and we have recently established a new reference population titled NORMXT2. This study was funded by CIHR.
Interested to see publications arising from our research? We use PubMed to keep track of our latest publications.