Osteoporosis is a major skeletal disease affecting 10 million Americans and is responsible for approximately 1.5 million fractures each year in the US. While low bone mass has long been associated with osteoporosis, the composition, structure, and distribution of the primary bone tissue constituents, mineral and collagen, are also altered in osteoporotic bone. Understanding the factors that contribute to skeletal fragility is essential for effective prevention and treatment of bone disease.
Bisphosphonates, the most common pharmacologic treatment for osteoporosis, prevent bone loss by inhibiting bone resorption. However, the optimal treatment duration is unknown, and recent reports of rare atypical fractures specifically associated with long-term bisphosphonate use suggest that prolonged treatment in some patients may reduce bone toughness. We characterize biopsies from bisphosphonate-naïve and bisphosphonate-treated women using Fourier transform infrared imaging (FTIRI) to understand how osteoporosis itself, as well as bisphosphonate treatment, alters bone tissue composition. The long-term translational goal of this work is to improve fracture prediction by incorporating measures of bone composition and material properties in addition to the current clinical standard of bone mineral density.