Osteoporosis: how the virtual physiological human can help...

Osteoporosis: how the

virtual physiologicalhuman can help in

fighting a pandemia

By Marco VicecontiProject Coordinator

Copyright © 2008-2012 VPHOP Consortium - All right reserved 2

Why Osteoporosis?

30 to 50% of all women and 15 to 30%of all men will face an osteoporotic

fracture in their lifetime

Osteoporosis is becoming pandemic

But …. It is a chronic disease. Nobodydies of osteoporosis, right?

WRONG!!


Osteoporosis is a killer

• OP fractures kill as many women as breast cancer.

• 4,000,000 fractures every year cost Europe!30,000,000,000.

• 250,000 elders will dies of related complicationswithin 12 month; all others will remain impaired.

• Forecast to double by 2050.


Not enough technology

• The technology in current clinicalpractice is clearly insufficient.

• The accuracy in predicting fracturesis as low as 60%.

• Even if we see the drugs are notworking we wait for the fracture,and only then surgically fix it.


OP fracture is multiscale

• Body musculoskeletal anatomy and neuromotorcontrol define the daily loading spectrum, whichincludes paraphysiological overloading events

• Fracture events occur at Organ level

• Tissue morphology defines the bone elasticity

• The Cell activity changes the tissue morphologyand composition over time

• The Constituent of the extracellular matrix arethe prime determinants of the tissue strength

The Europhysiome Initiative

http://www.europhysiome.org

© 2007 STEP Consortium

VPH Research Road Map

http://www.europhysiome.org/roadmap

© 2007 STEP Consortium

Virtual Physiological Human

is a methodological andtechnological framework thatonce established will enable

the investigation of the humanbody as a single complex

system

VPHOP:new technology tofight osteoporosis


Organ-level

model

Cell-level

modelConstituent-level

model

Tissue-level

model

The Hypermodel:primary systemic relationships

Body-level

model

Boundary

Conditions

Bone

Rem

odellin

g

Failure

Criterion

Constitutive

Equation


BioSpace EOS plus

Screening

Musculoskeletal model3D skeletal

anatomy


Neuromotor condition

Skeletal Loading historySLC Actibelt plus

Weekly recording


Risk of fracture

GEOMETRY and

DENSITY

?

FE MODEL RISK OF FRACTURE


Site at highest risk

Patient Tissue Imaging Tissue Morphology

DatabasePatient Specific Tissue

Structure


Predicting evolution over time

HORMONE-BASEDSIMULATION

CELL-BASEDSIMULATION

IN VIVO FRACTUREPREDICTION


Constituent level /2

Augmentation TechnologyAugmentation Technology

Biomaterial

Distribution

Biomaterial

DistributionRheological PropertiesRheological Properties

Flow SimulationFlow Simulation

Bone / Biomaterial

Constituents Interaction

Bone / Biomaterial

Constituents Interaction


From models to Hypermodels

Boundaryconditions

Constitu

tive

equati

on

FailurecriterionBone

remodell

ing

HYPERMODEL

http://www.vphop.eu


Disclaimer

• VPHOP is a project co-funded by the European CommissionSeventh FRAMEWORK PROGRAMME

• The research reported upon in this presentation has eitherdirectly or indirectly been supported by the EuropeanCommission, Directorate General Information Society andMedia, Brussels.

• The results, analyses and conclusions derived there fromreflect solely the views of its authors and of the presenter.

• The European Community is not liable for any use that maybe made of the information contained therein.

Osteoporosis: how the virtual physiological human can help...

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