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Updated: Jun 16 2021

Bone Remodeling

4.1

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Images
https://upload.orthobullets.com/topic/9008/images/Cutting cone_moved.jpg
  • Introduction
    • Wolff's Law
      • bone remodels in response to mechanical stress
    • Piezoelectric charges
      • bone remodels in response to electric charges
      • compression side is electronegative and stimulates osteoblast formation
      • tension side is electropostive and stimulates osteoclasts
    • Hueter-Volkmann Law
      • theory that bone remodels in small packets of cells known as Basic Multicellular Units (BMUs)
      • theory suggest that mechanical forces influence longitudinal growth
      • compressive forces inhibit growth
      • may play role in scoliosis
  • Remodeling Mechanism
    • Cortical bone
      • remodels by osteoclastic tunneling (cutting cone)
        • osteoclastic resorption > layering of osteoblasts > layering of lamellae > cement line laid down
        • osteoclast make up head of cutting cone, followed by capillaries and then osteoblasts which lay down the osteoid to fill the cutting cone
        • sclerostin inhibits osteoblastogenenesis to decrease bone formation
      • cortical bone continues to change over time
        • cortical area decreases as age increases
          • linked to increase fracture risk
        • medullary canal volume increases as age increases
    • Cancellous bone remodels by
      • osteoclastic resorption
      • osteoblastic deposition of layers of lamellae
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