Research in Ken Poole’s group focuses on osteoporotic fragility fractures and osteoarthritis by examining bone structure, shape and biology in health and disease. In collaboration with Cambridge University Engineering department, Ken’s team developed a way of assessing the 3D structure and shape of cortical bone structure in life called Cortical Bone Mapping (CBM). The Cambridge team 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, they found that both teriparatide and denosumab 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. In recent work, the team have identified and mapped the bone anabolic effects of romosozumab within human vertebrae. Ken splits his time 50:50 between research and clinical practice, looking after patients with osteoporosis, joint disease and rare bone diseases.