Fractures, in particular femoral neck (FN) fractures, are a huge public health problem resulting in disabilities, mortality and financial cost to the community. The prevention of these fractures is based on estimation of bone strength. The decision whether someone needs treatment, or the effectiveness of a treatment can only be judged by estimating bone strength. The bottom line is that currently we cannot correctly estimate bone strength. Present methods such as bone mineral density (BMD) perfo ....Fractures, in particular femoral neck (FN) fractures, are a huge public health problem resulting in disabilities, mortality and financial cost to the community. The prevention of these fractures is based on estimation of bone strength. The decision whether someone needs treatment, or the effectiveness of a treatment can only be judged by estimating bone strength. The bottom line is that currently we cannot correctly estimate bone strength. Present methods such as bone mineral density (BMD) perform poorly. Most people who fracture are not detected by BMD because their BMD is either normal or high, and many people with low BMD never fracture. The main aim of this grant application is to develop new tools to allow doctors and scientists worldwide to better estimate FN strength. To develop new methods to replace BMD, scientists need to make use of the 3D aspects of the bone such as size, shape and internal architecture. Presently, these 3D aspects (structure) have not been adequately studied and scientists incorrectly approximate them. As a result new methods are not any better. A good quantification of structure is needed. Another reason for the failure to accurately estimate the strength of bones is that estimates are based on a single parameter whereas the bone, like any architectural structure (e.g. building), comprises many components acting together to maintain its strength. To determine the strength based on density alone is incorrect; the size, the shape and things inside the structure need to be considered as a whole. After quantifying correctly the structure and components of bone strength, we will determine how they can be used individually and together to better estimate the strength of the FN in men and women. Tools generated will be used to better determine people likely to fracture and needing treatment; to better tailor and monitor treatments. A better understanding of the causes and epidemiology of fractures will ensue.Read moreRead less
Passive Mechanical Properties Of Muscle Fascicles And Tendons Of People With Contracture And Healthy Controls
Funder
National Health and Medical Research Council
Funding Amount
$221,872.00
Summary
Muscle contracture - abnormal stiffening of muscles - is common in many conditions, including stroke, spinal cord injury and multiple sclerosis. Contractures can be very disabling. The mechanisms of muscle contracture are poorly understood. This study will determine whether contractures of calf muscles in people with stroke, spinal cord injury and multiple sclerosis are due to changes in the mechanical properties of muscle fascicles or tendons.
Reducing Knee Load And Slowing Disease Progression With Conservative Interventions In Knee Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$271,503.00
Summary
Knee arthritis is a painful, disabling, costly condition particularly affecting the elderly. As there is presently no cure for arthritis, interventions that slow progression of the disease will reduce the personal and societal burden of arthritis. Recently it has been postulated that specific exercise that targets how the muscles are controlled by the nervous system may have greater disease-modifying effects than exercise aimed at strengthening the muscles. Data are beginning to highlight the co ....Knee arthritis is a painful, disabling, costly condition particularly affecting the elderly. As there is presently no cure for arthritis, interventions that slow progression of the disease will reduce the personal and societal burden of arthritis. Recently it has been postulated that specific exercise that targets how the muscles are controlled by the nervous system may have greater disease-modifying effects than exercise aimed at strengthening the muscles. Data are beginning to highlight the complexity of muscle strategies adopted by the nervous system to compensate for joint derangement in knee arthritis. It is our contention that there may be specific strategies that provide more optimal knee joint loading in relation to slowing disease progression. The first part of this project is to investigate knee control in people with knee arthritis and to evaluate whether this influences disease progression. This will provide the basis for refinement and optimisation of rehabilitation interventions for this patient group. The second part of this project will investigate whether strengthening the hip muscles in patients with knee arthritis influences knee load and hence disease progression. Hip muscle strengthening is currently not routinely included as part of the management of knee arthritis. If the results of this project find it to be effective, then hip muscle strengthening can be recommended for treating knee arthritis.Read moreRead less
Towards Predicting Brain Deformations For Image-guided Neurosurgery
Funder
National Health and Medical Research Council
Funding Amount
$304,281.00
Summary
We will significantly improve the efficiency of image-guided neurosurgery for brain tumours by creating a novel system to improve intra-operative visualisation and navigation utilising realistic prediction of brain deformations based on a biomechanical model. The system will create an augmented reality visualisation of the intra-operative configuration of the patient's brain merged with high resolution pre-operative imaging data in order to better localise the tumour and critical healthy tissues ....We will significantly improve the efficiency of image-guided neurosurgery for brain tumours by creating a novel system to improve intra-operative visualisation and navigation utilising realistic prediction of brain deformations based on a biomechanical model. The system will create an augmented reality visualisation of the intra-operative configuration of the patient's brain merged with high resolution pre-operative imaging data in order to better localise the tumour and critical healthy tissues.Read moreRead less
ANALYSIS OF KNEE KINEMATICS- An MRI Study Of The Normal, Anterior Cruciate Injured, And Reconstructed Knee.
Funder
National Health and Medical Research Council
Funding Amount
$161,320.00
Summary
People with anterior cruciate ligament damage to the knee tend to develop osteoarthritis in this knee, perhaps because the instability produced by the ligament tear changes the patterns of wear on the joint surfaces. There are several studies using cadaver knees which examine the impact on the joint surfaces of cutting the anterior cruciate ligament, but very little of people moving voluntarily. This study plans to use MRI images of people with a torn cruciate ligament in one knee, and one norma ....People with anterior cruciate ligament damage to the knee tend to develop osteoarthritis in this knee, perhaps because the instability produced by the ligament tear changes the patterns of wear on the joint surfaces. There are several studies using cadaver knees which examine the impact on the joint surfaces of cutting the anterior cruciate ligament, but very little of people moving voluntarily. This study plans to use MRI images of people with a torn cruciate ligament in one knee, and one normal knee. The subjects will simulate a squat inside the MRI magnet against a weighted footplate. The images will be taken at fifteen degree intervals of knee movement. The contact points between the joint surfaces will be measured and compared to the normal knee. This imaging will be repeated after surgical repair, and then again two years later, to assess whether the normal movement pattern has been restored.Read moreRead less
Bone Fragility: The Neglected Role Of Cortical Porosity
Funder
National Health and Medical Research Council
Funding Amount
$620,381.00
Summary
Cortical (outer shell) or compact bone constitutes 80% of the skeleton. It is not solid as implied by its name but made of inter-connected canals resembling a network of roads. We recently discovered that most of the bone loss with age occurs from these canals, not from t rabecular bone as currently believed. This suggests to know why and how bone breaks requires the study of the morphology of these canals and how they change with age. This is what we propose to do. It has never been done.
MALE OSTEOPOROSIS: A POPULATION-BASED STUDY IN GEELONG
Funder
National Health and Medical Research Council
Funding Amount
$432,645.00
Summary
Osteoporosis is a term used to indicate that bones have become thin and fragile. During the ageing process bone fragility increases and fractures occur more easily and more often. Fractures may also occur during normal daily activities, with fractures of the spine, forearm and hip being common. However, many other sites may fracture. This is a serious problem because fractures cause pain, disability and, sometimes, death. Although previously overshadowed by its effect in women, osteoporosis is i ....Osteoporosis is a term used to indicate that bones have become thin and fragile. During the ageing process bone fragility increases and fractures occur more easily and more often. Fractures may also occur during normal daily activities, with fractures of the spine, forearm and hip being common. However, many other sites may fracture. This is a serious problem because fractures cause pain, disability and, sometimes, death. Although previously overshadowed by its effect in women, osteoporosis is increasingly being recognised in men. In Australia, 39% of all fractures occur in men and prognosis for fracture in men is worse than in women. A consequence of increasing male longevity is that osteoporosis will affect a growing number of Australian men. It is anticipated that between 1996 and 2051, the number of men with fracture will double, with a 4-fold increase in the number of male hip fractures. Unless the problem of osteoporosis in men is addressed and effective interventions are implemented, the substantial health burden imposed by age-related fractures will continue to escalate. In this case-control study of fracture risk in men, men with fractures (cases) will be identified prospectively for 3 years from radiological reports. Controls will be selected concurrently, at random from electoral rolls. Anticipated number of cases and controls are 800 and 1400, respectively. Cases and controls will be characterised for risk factors for fracture: bone density and bone geometry will be measured, serum samples collected, and diet, lifestyle and medical history documented by questionnaire. The advantage of this type of data is that information from patients with fracture will be used to tell us about the risk of fracture in healthy, unaffected men and about the characteristics of the Australian male population at risk for fracture. The information can be used in decision making for the individual and in policy making for the whole population.Read moreRead less