Bone fracture in fragile elders
The VPHOP project produced a battery of radically innovative technologies to better predict the risk of bone fracture in osteoporosis patients. The VPH technologies were tested on four clinical cohorts: a retrospective cohort of 100 women, 50 who had a femoral neck fragility fracture, pair-matched by age, weight, height (Sheffield); a retrospective cohort of 71 women, 26 with femoral fracture, grow-matched by age, height, and weight (Reykjavik); a prospective cohort of 55 women with 22 femoral fractures (Reykjavik); and a 43 women with 19 non femoral fractures (Lyon).
The predictive accuracy of the patient-specific models based on the VPHOP technology showed improvements between 10% and 25% over the current standard of care predictors. If a patient at risk of fragility fractures is recognised and properly treated, she/he has 40-50% chances less to face an osteoporotic fracture. The improvement in predictive accuracy would avoid between 2% and 5% of the yearly incidence of OP fractures, depending on the referral criteria. OP fractures cost every year €37bn to Europe.
Most pessimistic figures would produce a cost reduction of €300m to €600m per year, for the 11400 femoral and vertebral fractures that the full-scale adoption of VPHOP technologies would involve.
Viceconti, M., Taddei, F., Cristofolini, L., Martelli, S., Falcinelli, C., Schileo, E., 2012. Are spontaneous fractures possible? An example of clinical application for personalised, multiscale neuro-musculo-skeletal modelling. J Biomech 45(3), 421-426. DOI:10.1016/j.jbiomech.2011.11.048
Falcinelli, C, Schileo E, Balistreri L, Baruffaldi F, Bordini B, Viceconti M, Albisinni U, Ceccarelli F, Milandri L, toni A, Taddei F, 2014. Multiple Loading Conditions Analysis can Improve the Association between Finite Element Bone Strength Estimates and Proximal Femur Fractures: a Preliminary Study in Elderly Women. Bone, in press.
Public dissemination: TEDxSheffield 2012 - www.youtube.com/watch;