title: Towards thein vivoprediction of fragility fractures with Raman spectroscopy.
abstract: Fragility fractures, those fractures which result from low level trauma, have a large and growing socio-economic cost in countries with aging populations. Bone-density-based assessment techniques are vital for identifying populations that are at higher risk of fracture, but do not have high sensitivity when it comes to identifying individuals who will go on to have their first fragility fracture. We are developing Spatially Offset Raman Spectroscopy (SORS) as a tool for retrieving chemical information from bone non-invasivelyin vivo. Unlike X-ray-based techniques SORS can retrieve chemical information from both the mineral and protein phases of the bone. This may enable better discrimination between those who will or will not go on to have a fragility fracture because both phases contribute to bone's mechanical properties. In this study we analyse excised bone with Raman spectroscopy and multivariate analysis, and then attempt to look for similar Raman signalsin vivousing SORS. We show in the excised work that on average, bone fragments from the necks of fractured femora are more mineralised (by 5-10%) than (cadaveric) non-fractured controls, but the mineralisation distributions of the two cohorts are largely overlapped. In ourin vivomeasurements, we observe similar, but as yet statistically underpowered, differences. After the SORS data (the first SORS measurements reported of healthy and diseased human cohorts), we identify methodological developments which will be used to improve the statistical significance of future experiments and may eventually lead to more sensitive prediction of fragility fractures. © 2015 The Authors.Journal of Raman SpectroscopyPublished by John Wiley & Sons, Ltd.
authors.affiliation: Central Laser Facility, Research Complex at Harwell STFC Rutherford Appleton Laboratory Harwell Oxford OX11 0FA UK; UCL Institute of Orthopaedics and Musculoskeletal Science London HA7 4LP UK; Royal National Orthopaedic Hospital Stanmore HA7 4LP UK.
authors.forename: Kevin
authors.initials: K
authors.lastname: Buckley
authors.affiliation: UCL Institute of Orthopaedics and Musculoskeletal Science London HA7 4LP UK; Royal National Orthopaedic Hospital Stanmore HA7 4LP UK.
authors.forename: Jemma G
authors.initials: JG
authors.lastname: Kerns
authors.affiliation: Royal National Orthopaedic Hospital Stanmore HA7 4LP UK.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Vinton
authors.affiliation: UCL Institute of Orthopaedics and Musculoskeletal Science London HA7 4LP UK; Royal National Orthopaedic Hospital Stanmore HA7 4LP UK.
authors.forename: Panagiotis D
authors.initials: PD
authors.lastname: Gikas
authors.affiliation: UCL Institute of Orthopaedics and Musculoskeletal Science London HA7 4LP UK.
authors.forename: Christian
authors.initials: C
authors.lastname: Smith
authors.affiliation: Central Laser Facility, Research Complex at Harwell STFC Rutherford Appleton Laboratory Harwell Oxford OX11 0FA UK; UCL Institute of Orthopaedics and Musculoskeletal Science London HA7 4LP UK; Royal National Orthopaedic Hospital Stanmore HA7 4LP UK.
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Parker
authors.affiliation: Central Laser Facility, Research Complex at Harwell STFC Rutherford Appleton Laboratory Harwell Oxford OX11 0FA UK; UCL Institute of Orthopaedics and Musculoskeletal Science London HA7 4LP UK; Royal National Orthopaedic Hospital Stanmore HA7 4LP UK.
authors.forename: Pavel
authors.initials: P
authors.lastname: Matousek
authors.affiliation: UCL Institute of Orthopaedics and Musculoskeletal Science London HA7 4LP UK.
authors.forename: Allen E
authors.initials: AE
authors.lastname: Goodship
keywords: SORS; bone disease; clinical investigation; in vivo; medical diagnostics