Bone strength and ultrastructure

Excerpt

Bone is programmed to withstand low-energy trauma and repeated stimuli such as walking, running, and jumping to an extent. The ability of bone to withstand physiological stress is governed by not only its determinants including mass, geometry, and microarchitecture but also intrinsic bone tissue quality. Intrinsic bone tissue quality is governed by the degree of mineralization and matrix characteristics such as collagen fiber orientation and chemical structure, both of which help to characterize the bone ultrastructure, and while the exact roles these determinants play are poorly understood, they appear to be crucial for the overall understanding of bone mechanical properties. These determinants are affected by bone remodeling and may therefore be considered as targets of nutritional, hormonal, and therapeutic intervention and activity. If we are to understand how bone adapts to a loss of mass and responds to pathophysiological alteration or to treatment, all such affected contituents need to be considered systematically, including intrinsic bone tissue quality. …