Welcome to the Building Better Bones game at Scientifica 2021!  At the Laboratory for Bone Biomechanics at the ETH Zurich we aim to help doctors select the best treatment for patients with bone diseases by using computer simulations to predict what will happen to each patient’s bone with each treatment.

Long bones consist of cortical and trabecular bone. You might think that bone is static and stern tissue, but it is actually a very active tissue that can adapt to its environment. Bone can remodel itself using three kind of cells: osteoblasts to form new bone, osteoclasts to resorb bone and osteocytes to orchestrate the process. The remodeling activity is much higher in the trabecular bone. Over the course of 7-10 years, the equivalent of the whole body’s bone mass is remodelled!

In the following game, we ask for your help in treating two patients with diseases that affect bone health: Matthias has diabetes and Mary has osteoporosis and both of them are at risk of breaking their arm. Whoever finds the best treatment and exercise regime to maximize their bone density will win a bone biomechanics prize!

We start off with scans of Matthias and Mary’s arms and measurements of the resorption and formation going on over a few weeks:

Mary’s osteoporotic bone

Bone density is low and both resorption and formation are high, with resorption even higher than formation

Matthias’ diabetic bone

Bone density is high but the microstructure is weak and bone resorption and formation are both low.

To determine the best treatment, we simulate what happens to each bone with each of 3 of the treatments approved for use today that have shown to improve bone density the most.

Bisphosphonates bind bone and protect it from resorption

Denosumab  prevents formation of osteoclasts

PTH increases activity and number of osteoblasts

Romo stops the signal from osteocytes to osteoblasts to stop forming bone.

Exercise has a very important effect on bone! Astronauts lose 1 to 2 % bone density per month in the international space station and professional tennis players have a significantly higher bone density in the serving arm! This happens because the cells in the bone can sense applied loads and remodel bone to make it stronger where needed! We will simulate how exercise would affect Matthias and Mary’s bones! 

Desk job, car, bar

Driving your car to a desk job and back every day is not enough, please exercise regularly or you will be in the high risk group for bone fractures

Regular exercise

Please exercise regularly! It will improve all aspects of your health, including a reduction in the risk of bone fracture!