Beyond Bone Density: NIH-Funded Research on BoneScore Draws a Sold-Out Crowd at ASBMR 2026

Simon Tang, PhD, presented work on measuring bone quality directly, building on his team’s peer-reviewed study in Clinical Orthopaedics and Related Research®

SANTA BARBARA, CA, UNITED STATES, October 15, 2026 /EINPresswire.com/ — BoneScore^® (Active Life Scientific, Inc.) today shared highlights from the American Society for Bone and Mineral Research (ASBMR) 2026 Annual Meeting in Boston. There, Washington University School of Medicine in St. Louis researcher Simon Y. Tang, PhD, presented his lab’s research on BoneScore to a sold-out bone-quality symposium. The talk highlighted his lab’s breakthroughs and walked the audience through the science behind the procedure, from how the test quantifies bone material strength, to whole bones broken in the laboratory, to early work on spinal screw fixation. It built on the team’s peer-reviewed cadaver study, published in July in Clinical Orthopaedics and Related Research^® (CORR).

Most fragility fractures happen in people whose bone density is not in the osteoporotic range. In one population study of women, 73.1% of fractures occurred in women without osteoporosis.[2] Density shows how much bone is there. BoneScore measures bone material strength, with a single reading at the shin.

“Correlating bone material strength with other methods for diagnosing bone health is an important first step,” said Dr. Tang, Professor of Orthopaedic Surgery at Washington University School of Medicine. “The bigger opportunity is understanding fracture susceptibility, meaning who is most vulnerable, and that’s where our research is heading.”

What the Published Study Found

In the CORR study, the team took a BoneScore reading (the Bone Material Strength index, or BMSi) at the shin of 67 female donors. Then they broke each donor’s hip, wrist and spine bones in the laboratory and compared the results with DXA bone density.[1]

– Stronger link to hip strength. BMSi correlated with femur strength at r = 0.62, compared with r = 0.45 for total hip bone density.
– Sorted the weaker hips. Using an estimated sideways-fall load for each donor, BMSi separated the femurs that failed from those that held (AUC 0.75, BMSi, hip). Total hip density did not (AUC 0.62, total hip BMD, hip; p = 0.08).
– Tracked strength where density didn’t. In donors with osteopenia or normal density, BMSi still tracked femur strength (r = 0.61 and r = 0.58). Total hip density did not.
– Better together. Adding BMSi to total hip density nearly doubled the share of femur strength explained, from 28% to 52%.
– Matched density at the wrist (AUC 0.77, BMSi, vs AUC 0.78, total hip BMD).
– Tracked toughness. In bone specimens, BMSi correlated with fracture toughness at r = 0.83.

Rachana S. Vaidya, PhD, first author of the study and a researcher in the Department of Orthopaedic Surgery at Washington University School of Medicine in St. Louis, led the analyses. She and her co-authors conclude that BMSi “provides complementary information to BMD and captures aspects of bone quality that cannot be measured clinically without destructive testing.”[1]

What’s Next: More Donors, Men, and the Operating Room

In Boston, Dr. Tang previewed preliminary results from an expanded cohort of 116 donors that includes men. He compared BMSi with hip DXA and FRAX, the standard fracture-risk calculator.

“If we look at just the non-osteoporotic donors, BMSi continues to be a really good discriminator,” Dr. Tang said. “BMD’s accuracy drops quite a bit, and FRAX doesn’t appear to work in this group.”

Dr. Tang also shared early, preliminary laboratory work on spinal surgery, where screws that loosen over time can lead to repeat operations. Surgeons often use CT scans, measured in Hounsfield Units, to judge how well vertebral bone will hold a screw. In pull-out tests, CT worked well for clearly strong or clearly weak bone, but bone in the middle range was harder to call. “In that middle range, two vertebrae can look the same on CT and hold a screw very differently,” he said. “Measuring BMSi right at the screw site helped us tell them apart.”

“All these different laboratory measurements are great. They measure different aspects of bone quality,” Dr. Tang added. “With BoneScore now available in the clinical setting, we should be thinking about how to integrate it with other measures, and identify which patient populations benefit most.”

A Clinician’s View

Natasha M. Appelman-Dijkstra, MD, PhD, is Professor of Internal Medicine (bone and mineral disorders) at Leiden University Medical Center, where she directs the Center for Bone Quality. She has been using BoneScore technology and its impact microindentation technique in clinical care and research since 2014.[3]

“Every week in our clinic we see patients whose bone density doesn’t tell the whole story,” said Dr. Appelman-Dijkstra. “Measuring bone material strength directly gives us a dimension of bone quality we’ve been missing. Work like Dr. Tang’s is helping the field understand the basic science behind it and where it adds the most value for our patients.”

Looking Ahead

“For decades, bone health has been measured by quantity. Researchers like Dr. Tang are showing what becomes possible when we can measure quality, too,” said Alexander Proctor, Founder & CEO of Active Life Scientific. “With BoneScore now clinically available, measuring bone material strength is no longer limited to the research lab. Our goal is simple: make checking bone strength as routine as checking blood pressure.”

Available to Clinicians Today

BoneScore gives clinicians a direct measure of bone material strength from a single, radiation-free reading at the shin. The procedure uses an FDA-cleared device, available by prescription in the United States and CE-marked in Europe and the United Kingdom, and reports results as the Bone Material Strength index (BMSi).

Physicians can learn more about BoneScore at: https://bonescore.com/physician/

A Category III CPT code, 0547T, has been established for impact microindentation. Category III codes are used to report and track emerging technologies. Coverage and payment are determined independently by individual payers and are not guaranteed.

Read the study: pubmed.ncbi.nlm.nih.gov/42390157

About the Study

The CORR study was conducted at Washington University School of Medicine in St. Louis, with co-authors from the School of Medicine, St. Louis University. The authors’ institution received National Institutes of Health funding during the study period (P30AR074992; S10OD028573). Active Life Scientific provided in-kind technical assistance and feedback. The study used deceased female donors; in the authors’ words, its results reflect “the intrinsic mechanical competence of bone rather than dynamic fracture risk in living individuals,” and prospective clinical studies are the next step. Analyses previewed at ASBMR 2026 are preliminary. The expanded-cohort and spine work previewed in Boston is supported by NIH grant R44AG071034, awarded to Active Life Scientific. Clinical Orthopaedics and Related Research^® neither advocates nor endorses the use of any treatment, drug, or device. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

References

[1] Vaidya RS, Jahani B, Jin JM, Gonzalez CC, Pujari B, Krothapalli S, Tang SY. Impact microindentation evaluates bone strength, bone quality, and fracture susceptibility across skeletal sites: a cadaver study. Clin Orthop Relat Res. 2026 Jul 2 (online ahead of print). DOI 10.1097/CORR.0000000000004033. PMID 42390157.

[2] Pasco JA, Seeman E, Henry MJ, et al. The population burden of fractures originates in women with osteopenia, not osteoporosis. Osteoporos Int. 2006;17(9):1404–1409. DOI 10.1007/s00198-006-0135-9.

[3] Schöb M, Hamdy NAT, Malgo F, Winter EM, Appelman-Dijkstra NM. Added value of impact microindentation in the evaluation of bone fragility: a systematic review of the literature. Front Endocrinol. 2020;11:15. DOI 10.3389/fendo.2020.00015.

About BoneScore

BoneScore^® measures bone material strength directly, with a single reading at the shin using the FDA-cleared OsteoProbe^® (De Novo DEN210013; K250216). Results are reported as the Bone Material Strength index (BMSi), and the procedure is billed under CPT code 0547T. BoneScore is backed by more than 200 published papers from more than 70 institutions and is in use at leading centers including Mayo Clinic, Vanderbilt, Scripps and HSS. Active Life Scientific, Inc. spun out of the University of California, Santa Barbara in 2007 and builds every OsteoProbe in its ISO 13485-certified facility in Santa Barbara, California. Learn more at bonescore.com.

Important information. The OsteoProbe is a measurement tool intended to assess bone tissue resistance to microindentation on the tibia of adults, reported as the Bone Material Strength Index (BMSi). In laboratory studies, BMSi measurements have been shown to correlate with biomechanical properties of bone, including whole-bone strength and fracture toughness. The clinical significance of laboratory-based biomechanical studies is unknown. The device is not intended to diagnose disease, predict fracture risk, or treat any clinical condition. Prescription use only, by or on the order of a physician. Investigator statements are their own.

BoneScore and OsteoProbe are registered trademarks of Active Life Scientific, Inc.

George England
BoneScore
+1 805-770-2600
george@bonescore.com
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