Bone quality and bone strength: benefits of the bone-forming approach

Abstract

summaryThe ability of bone to resist fracture depends on the intrinsic properties of the materials that comprise the bone matrix mineralization, the amount of bone (i.e. mass), and the spatial distribution of the bone mass (i.e. microarchitecture). Antiresorptive agents may prevent the decay of cancellous bone and cortical thinning, with no improvement of bone microstructure, leading to a partial correction of the principal bone quality defect in osteoporosis, the disruption of trabecular microarchitecture. Anabolic agents promote bone formation at both trabecular and endocortical surfaces, resulting in an increase of cancellous bone volume and cortical thickness. The improvement of cortical bone strength may be limited by an increase in cortical porosity. strontium ranelate improves trabecular network and cortical thickness that will contribute to anti-fracture efficacy at both vertebral and non-vertebral sites. The results of clinical and experimental studies are consistent with the mode of action of strontium involving dissociation between bone formation and resorption leading to a stimulation both trabecular and cortical bone formation without increasing cortical porosity.key words: strontium ranelate; bone quality; cortical bone.

High-Resolution Tomography-Based Quantification of Cortical Porosity and Cortical Thickness at the Surgical Neck of the Humerus During Aging

“…Previous studies almost exclusively focused on the trabecular bone [9], whereas more recent investigations on the radius, tibia, and femur have clearly identified the cortical bone as mainly contributing to the bone loss [11,16,22]. In accordance to those studies, the major findings regarding the surgical neck of the proximal humerus show that (1) Ct.Po increases during aging, (2) Ct.Th concurrently decreases, and (3) the highest microstructural changes at the cortex occur around the age of 65 years.…”

Prolonged performance of a high repetition low force task induces bone adaptation in young adult rats, but loss in mature rats

“…Numbers of osteoclasts (multinucleated TRAP+ cells) per bone surface (N.Oc/BS) were counted in TRAP stained sections on trabecular surfaces in the secondary spongiosa, using a Nikon E800 microscope interfaced with an image analysis program (Bioquant Osteo 2012 v12.1). Since TRAP is also known to stain macrophages and other mononuclear cells of the monocyte-macrophage lineage [65–68], only large cells with 3 or more nuclei were counted, as previously described. Osteoclast resorption spaces (number per bone surface area; defined as spaces in cortical bone in which osteoclasts were present) and arterial spaces were counted in mid-diaphyseal cortical bone.…”

Effects of Preventive Long-Term Treatment with Strontium Ranelate and Zoledronic Acid on Bone Quality in Ovariectomized Rats

“…Strontium ranelate, a therapeutic option for osteoporosis, was thought to have a dual mode of action, simultaneously stimulating bone formation and reducing resorption [14]. ZA, a bisphosphonate, is a potent antirresorptive agent [2].…”