Research

Research in the bone group focuses on osteoporotic fragility fractures and osteoarthritis by examining bone structure, shape and biology in health and disease. As part of a team led by imaging experts Graham Treece and Andrew Gee from the University Engineering department, we developed a way of assessing the 3D structure and shape of cortical bone in life called Cortical Bone Mapping (CBM). We have used CBM, histology and microCT to discover that there are defined patches of focal osteoporosis in older people’s femurs that predispose them to hip fracture. CBM measurements from clinical CT predict hip fracture well. Analysing separate clinical trials, we found that teriparatide PTH1-34 and denosumab anti-RANK ligand antibody treatment of osteoporotic women improved bone in patches of the femur at risk of fracture. Older men undertaking high-impact short-duration exercise (the HIPHOP study) also responded well, with focal patches of cortical bone improving on CT.

Within the Department of Medicine, we represent the Division of Rheumatology and within Cambridge NIHR Biomedical Research Centre we represent the 'Metabolism, Endocrinology and Bone'  theme. Evelyn Trust funding allowed us to purchase the UK’s first high resolution Xtreme CT scanner, and have supported clinical radiology researcher Dr Tom Turmezei to carry forward the shape and image analysis techniques into the field of osteoarthritis. He has published key papers on the assessment of hip osteoarthritis with novel CT techniques. We make use of the Wellcome Trust Clinical Research Facility (WTCRF) for our clinical studies. Our clinical trials research includes an investigator-led  proof of concept study demonstrating that a single dose of intravenous zoledronate prevents bone loss after stroke.

The National Institute for Health Research (Research for Patient Benefit), Versus Arthritis, the Medical Research Council, the Evelyn Trust, the National Osteoporosis Society, Addenbrooke's Charitable Trust and the Cambridge NIHR Biomedical Research Centre support our current research program.

Selected Publications

1. Turmezei TD, Low SB, Rupret S, Treece GM, Gee AH, MacKay JW, Lynch JA, Poole KES, Segal NA. Quantitative Three-dimensional Assessment of Knee Joint Space Width from Weight-bearing CT. Radiology. 2021;299(3):649-59. https://www.ncbi.nlm.nih.gov/pubmed/33847516
2. Evans J, Sapsford M, McDonald S, Poole KES, Raine T, Jadon D. Prevalence of axial spondyloarthritis in patients with inflammatory bowel disease using cross-sectional imaging: a systematic literature review. Therapeutic Advances in Musculoskeletal Disease 2021
   
3. Aggarwal V, Maslen C…. Poole KES (2021). Opportunistic diagnosis of osteoporosis, fragile bone strength and vertebral fractures from routine CT scans; a review of approved technology systems and pathways to implementation. Therapeutic Advances in Musculoskeletal Disease. 2021;13
   
4. Rikkonen T, Sund R, Sirola J, Honkanen R, Poole KES, Kroger H. Obesity is associated with early hip fracture risk in postmenopausal women: a 25-year follow-up.Osteoporosis International. 2021;32(4):769-77
   
5. Hartley A, Hardcastle SA, Frysz M, Parkinson J, Paternoster L, McCloskey E, Poole, KES et al. Increased development of radiographic hip osteoarthritis in individuals with high bone mass: a prospective cohort study. Arthritis Research & Therapy. 2021;23(1)
   
6. Hartley A, Hardcastle SA, Paternoster L, McCloskey E, Poole KES, Javaid MK, Aye M, Moss K, Granell R, Gregory J, Williams M, Tobias JH, Gregson CL. Individuals with high bone mass have increased progression of radiographic and clinical features of knee osteoarthritis Osteoarthritis and Cartilage. 2020; 28(9): 1180-90 .https://pubmed.ncbi.nlm.nih.gov/32417557/
7. Mullins W, Jarvis GE, Oluboyede D, Skingle L, Poole KES, Turmezei TD, Brassett C The Segond fracture occurs at the site of lowest sub-entheseal trabecular bone volume fraction on the tibial plateau. J Anat 2020 Aug 8. https://pubmed.ncbi.nlm.nih.gov/32770847/
8. (Collaborator) Turro E and the NIHR BioResource–Rare Diseases, 100,000 Genomes Project–Rare Diseases Pilot. Whole-genome sequencing of patients with rare diseases in a national health system. Nature 583(7814):96-102 Jul 2020. https://pubmed.ncbi.nlm.nih.gov/32581362/
9. Turmezei T, Treece G, Gee A, Sigurdsson S, Jonsson H, Aspelund T, Gudnason V, Poole KES. Quantitative 3D imaging parameters improve prediction of hip osteoarthritis outcome Scientific Reports 2020 Mar 5;10(1):4127. https://pubmed.ncbi.nlm.nih.gov/32139721/

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