Localized bone deterioration predicts declining failure load and increased fracture risk
Authors' conclusion
Void spaces increased with age, progressed slower in males, and were strongly associated with reduced bone strength, especially at the tibia. While the impact on fracture risk was modest, void space may serve as an early marker of skeletal deterioration, supporting the potential role in osteoporosis monitoring.
Study context
- Population
- Participants of a longitudinal population study (63.2% female); mean age 53.7 ± 15.3 years; HR-pQCT of distal radius and tibia63.2% female
- Participants
- 603 participants
- Outcome
- Void space progression (VS/TV [%]) by age, sex and site
- Follow-up
- Mean 6.8 ± 1.8 years
Methodological detailsHR-pQCT at two visits 3-10 years apart, linear mixed-effects models
- HR-pQCT at two visits 3-10 years apart
- Linear mixed-effects models
Main finding
As reported in the abstract
Void space (VS/TV) progression
Void space increase per year of age
0.02%
p< 0.001
Males: lower VS/TV at baseline and slower progression (p< 0.001)
1.04%
Observational data: associations, not effects.
Further findings
Association of 1% increase in VS/TV with fracture risk
- Increase in fracture risk (p< 0.01)
- 0.5%
Association of 1% increase in VS/TV with failure load
- Reduction in failure load at the radius (p = 0.073)
- 31.6 N
- Reduction in failure load at the tibia (p = 0.006)
- 111.3 N
Original publication
Localized bone deterioration predicts declining failure load and increased fracture risk. Osteoporos Int. Published 29 October 2025. doi:10.
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