A biomechanical perspective on bone quality
Observations that dual-energy X-ray absorptiometry (DXA) measures of areal bone mineral density cannot completely explain fracture incidence after anti-resorptive treatment have led to renewed interest in bone quality. Bone quality is a vague term but generally refers to the effects of skeletal fact...
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| Veröffentlicht in: | Bone (New York, N.Y.) N.Y.), 2006-12, Vol.39 (6), p.1173-1181 |
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| creator | Hernandez, C.J. Keaveny, T.M. |
| description | Observations that dual-energy X-ray absorptiometry (DXA) measures of areal bone mineral density cannot completely explain fracture incidence after anti-resorptive treatment have led to renewed interest in bone quality. Bone quality is a vague term but generally refers to the effects of skeletal factors that contribute to bone strength but are not accounted for by measures of bone mass. Because a clinical fracture is ultimately a mechanical event, it follows then that any clinically relevant modification of bone quality must change bone biomechanical performance relative to bone mass. In this perspective, we discuss a framework for assessing the clinically relevant effects of bone quality based on two general concepts: (1) the biomechanical effects of bone quality can be quantified from analysis of the relationship between bone mechanical performance and bone density; and (2) because of its hierarchical nature, biomechanical testing of bone at different physical scales ( |
| doi_str_mv | 10.1016/j.bone.2006.06.001 |
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Bone quality is a vague term but generally refers to the effects of skeletal factors that contribute to bone strength but are not accounted for by measures of bone mass. Because a clinical fracture is ultimately a mechanical event, it follows then that any clinically relevant modification of bone quality must change bone biomechanical performance relative to bone mass. In this perspective, we discuss a framework for assessing the clinically relevant effects of bone quality based on two general concepts: (1) the biomechanical effects of bone quality can be quantified from analysis of the relationship between bone mechanical performance and bone density; and (2) because of its hierarchical nature, biomechanical testing of bone at different physical scales (<1 mm, 1 mm, 1 cm, etc.) can be used to isolate the scale at which the most clinically relevant changes in bone quality occur. As an example, we review data regarding the relationship between the strength and density in excised specimens of trabecular bone and highlight the fact that it is not yet clear how this relationship changes during aging, osteoporosis development, and anti-resorptive treatment. Further study of new and existing data using this framework should provide insight into the role of bone quality in osteoporotic fracture risk.</description><identifier>ISSN: 8756-3282</identifier><identifier>EISSN: 1873-2763</identifier><identifier>DOI: 10.1016/j.bone.2006.06.001</identifier><identifier>PMID: 16876493</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aging ; Aging - physiology ; Biological and medical sciences ; Biomechanical Phenomena ; Biomechanics ; Biomechanics. Biorheology ; Bone and Bones - anatomy & histology ; Bone and Bones - physiology ; Bone Density ; Bone quality ; Diseases of the osteoarticular system ; Fractures, Bone - etiology ; Fractures, Bone - physiopathology ; Fundamental and applied biological sciences. Psychology ; Humans ; Medical sciences ; Osteoporosis ; Osteoporosis. Osteomalacia. 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Bone quality is a vague term but generally refers to the effects of skeletal factors that contribute to bone strength but are not accounted for by measures of bone mass. Because a clinical fracture is ultimately a mechanical event, it follows then that any clinically relevant modification of bone quality must change bone biomechanical performance relative to bone mass. In this perspective, we discuss a framework for assessing the clinically relevant effects of bone quality based on two general concepts: (1) the biomechanical effects of bone quality can be quantified from analysis of the relationship between bone mechanical performance and bone density; and (2) because of its hierarchical nature, biomechanical testing of bone at different physical scales (<1 mm, 1 mm, 1 cm, etc.) can be used to isolate the scale at which the most clinically relevant changes in bone quality occur. As an example, we review data regarding the relationship between the strength and density in excised specimens of trabecular bone and highlight the fact that it is not yet clear how this relationship changes during aging, osteoporosis development, and anti-resorptive treatment. Further study of new and existing data using this framework should provide insight into the role of bone quality in osteoporotic fracture risk.</description><subject>Aging</subject><subject>Aging - physiology</subject><subject>Biological and medical sciences</subject><subject>Biomechanical Phenomena</subject><subject>Biomechanics</subject><subject>Biomechanics. Biorheology</subject><subject>Bone and Bones - anatomy & histology</subject><subject>Bone and Bones - physiology</subject><subject>Bone Density</subject><subject>Bone quality</subject><subject>Diseases of the osteoarticular system</subject><subject>Fractures, Bone - etiology</subject><subject>Fractures, Bone - physiopathology</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Osteoporosis</subject><subject>Osteoporosis. Osteomalacia. Paget disease</subject><subject>Tissues, organs and organisms biophysics</subject><subject>Treatments</subject><issn>8756-3282</issn><issn>1873-2763</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkctKAzEUhoMotlZfwIXMRjcyNZeZXEAEKd5AcKPrkMmc2pTppE2mBd_eDC1eNgoHAjnfuf0_QqcEjwkm_Go-rnwLY4oxH_eByR4aEilYTgVn-2goRclzRiUdoKMY5xhjpgQ5RAPCpeCFYkN0eZtVzi_AzkzrrGmyJYS4BNu5DWS-zfoJ2WptGtd9HKODqWkinOzeEXq7v3udPObPLw9Pk9vn3JYSdzkpSiWZkIQqYQoluKCVNNySypiKqLqQVVnWpuAYuFLpvxayYkJhJgQlU2AjdLPtu1xXC6gttF0wjV4GtzDhQ3vj9O9M62b63W90up2nu1KDi12D4FdriJ1euGihaUwLfh01lxRLKcS_IFElJZyXCaRb0AYfY4Dp1zYE694MPde9VLo3Q_eBSSo6-3nHd8lO_QSc7wATk_bTYFrr4jeXVEw69tOvtxwk1TcOgo7WQWuhdiFZpWvv_trjE2krpvI</recordid><startdate>20061201</startdate><enddate>20061201</enddate><creator>Hernandez, C.J.</creator><creator>Keaveny, T.M.</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20061201</creationdate><title>A biomechanical perspective on bone quality</title><author>Hernandez, C.J. ; Keaveny, T.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c580t-145983781297a497672b8a6c1baab19d48b55da460e6996c1d78b379037721fe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Aging</topic><topic>Aging - physiology</topic><topic>Biological and medical sciences</topic><topic>Biomechanical Phenomena</topic><topic>Biomechanics</topic><topic>Biomechanics. Biorheology</topic><topic>Bone and Bones - anatomy & histology</topic><topic>Bone and Bones - physiology</topic><topic>Bone Density</topic><topic>Bone quality</topic><topic>Diseases of the osteoarticular system</topic><topic>Fractures, Bone - etiology</topic><topic>Fractures, Bone - physiopathology</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Osteoporosis</topic><topic>Osteoporosis. Osteomalacia. Paget disease</topic><topic>Tissues, organs and organisms biophysics</topic><topic>Treatments</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hernandez, C.J.</creatorcontrib><creatorcontrib>Keaveny, T.M.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Bone (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hernandez, C.J.</au><au>Keaveny, T.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A biomechanical perspective on bone quality</atitle><jtitle>Bone (New York, N.Y.)</jtitle><addtitle>Bone</addtitle><date>2006-12-01</date><risdate>2006</risdate><volume>39</volume><issue>6</issue><spage>1173</spage><epage>1181</epage><pages>1173-1181</pages><issn>8756-3282</issn><eissn>1873-2763</eissn><abstract>Observations that dual-energy X-ray absorptiometry (DXA) measures of areal bone mineral density cannot completely explain fracture incidence after anti-resorptive treatment have led to renewed interest in bone quality. Bone quality is a vague term but generally refers to the effects of skeletal factors that contribute to bone strength but are not accounted for by measures of bone mass. Because a clinical fracture is ultimately a mechanical event, it follows then that any clinically relevant modification of bone quality must change bone biomechanical performance relative to bone mass. In this perspective, we discuss a framework for assessing the clinically relevant effects of bone quality based on two general concepts: (1) the biomechanical effects of bone quality can be quantified from analysis of the relationship between bone mechanical performance and bone density; and (2) because of its hierarchical nature, biomechanical testing of bone at different physical scales (<1 mm, 1 mm, 1 cm, etc.) can be used to isolate the scale at which the most clinically relevant changes in bone quality occur. 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| subjects | Aging Aging - physiology Biological and medical sciences Biomechanical Phenomena Biomechanics Biomechanics. Biorheology Bone and Bones - anatomy & histology Bone and Bones - physiology Bone Density Bone quality Diseases of the osteoarticular system Fractures, Bone - etiology Fractures, Bone - physiopathology Fundamental and applied biological sciences. Psychology Humans Medical sciences Osteoporosis Osteoporosis. Osteomalacia. Paget disease Tissues, organs and organisms biophysics Treatments |
| title | A biomechanical perspective on bone quality |
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