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Bone Microdamage and Skeletal Fragility in Osteoporotic and Stress Fractures
Author(s) -
Burr David B.,
Forwood Mark R.,
Fyhrie David P.,
Martin R. Bruce,
Schaffler Mitchell B.,
Turner Charles H.
Publication year - 1997
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1359/jbmr.1997.12.1.6
Subject(s) - fragility , osteoporosis , bone remodeling , fragility fracture , medicine , endocrinology , bone mineral , chemistry
The accumulation of bone microdamage has been proposed as one factor that contributes to increased skeletal fragility with age and that may increase the risk for fracture in older women. This paper reviews the current status and understanding of microdamage physiology and its importance to skeletal fragility. Several questions are addressed: Does microdamage exist in vivo in bone? If it does, does it impair bone quality? Does microdamage accumulate with age, and is the accumulation of damage with age sufficient to cause a fracture? The nature of the damage repair mechanism is reviewed, and it is proposed that osteoporotic fracture may be a consequence of a positive feedback between damage accumulation and the increased remodeling space associated with repair.