The Influence of Cortical Porosity on the Strength of Bone During Growth and Advancing Age

AbstractPurpose of ReviewBone densitometry provides a two-dimensional projected areal apparent bone mineral density that fails to capture the heterogeneity of bone ’s material composition and macro-, micro-, and nano-structures critical to its material and structural strength. Assessment of the structural basis of bone fragility has focused largely on trabecular bone based on the common occurrence of fragility fractures at sites with substantial amounts of t rabecular bone. This review focuses on the contribution of cortical bone to bone fragility throughout life.Recent FindingsAccurately differentiating cortical and trabecular bone loss has important implications in quantifying bone fragility as these compartments have differing effects on bone strength. Recent advances in imaging methodology have improved distinction of these two compartments by (i) recognition of a cortico-trabecular transitional zone and (ii) quantifying bone microstructure in a region of interest that is a percentage of bone length rather than a fixed point. Additionally, non-invasive three-dimensional imaging methods allow more accurate quantification of changes in the cortical, trabecular, and cortico-trabecular compartments during growth, aging, disease, and treatment.SummaryOver 75% of the skeleton is assembled as cortical bone. Of all fragility fractures, ~  80% are appendicular and involve regions rich in cortical bone and ~ 70% of all age-related appendicular bone loss is cortical and is mai...
Source: Current Osteoporosis Reports - Category: Orthopaedics Source Type: research