Bone Stress Injuries Are Associated With Differences in Bone Microarchitecture in Male Professional Soldiers

Area of Science:

• Orthopaedic Research
• Bone Biology
• Sports Medicine

Background:

• Bone stress injuries (BSIs) are common in athletes and military personnel due to repetitive loading.
• The pathophysiology of BSIs is multifactorial, involving bone's response to mechanical stress.
• Understanding bone microstructure is crucial for identifying individuals at higher risk.

Purpose of the Study:

• To investigate bone microstructure and density differences in soldiers with tibial BSIs.
• To assess volumetric bone mineral density (vBMD) and areal bone mineral density (aBMD).
• To examine early-phase bone turnover markers.

Main Methods:

• Cross-sectional study comparing 26 soldiers with BSIs (case group) to 50 healthy soldiers (control group).
• High-resolution peripheral quantitative computed tomography (HR-pCT) for tibial and radial bone microstructure and vBMD.
• Dual-energy X-ray absorptiometry (DXA) and calcaneal laser assessment for aBMD.

Main Results:

• Reduced cortical bone mineral density at the radius and tibia in the BSI group.
• Lower trabecular number and thickness, and increased inhomogeneity in the tibia of the BSI group.
• Significantly reduced calcaneal bone density in the BSI group compared to controls.

Conclusions:

• Soldiers with BSIs exhibit distinct differences in bone microarchitecture compared to healthy peers.
• These microstructural alterations, including reduced cortical density and altered trabecular structure, may compromise biomechanical properties.
• Impaired bone microarchitecture is a potential risk factor for developing bone stress injuries.