“…We have previously used such computational models to provide support for the hypothesis that stem cell fate during fracture healing is governed by the local oxygen concentration and stiffness of the surrounding substrate (Burke and Kelly, 2012;Burke et al, 2013Burke et al, , 2014. This algorithm was developed based on in-vitro observations which demonstrate the fundamental role played by substrate stiffness in regulating MSC lineage commitment (Engler et al, 2006;Huebsch et al, 2010;Young et al, 2013;Park et al, 2011), and by experiments demonstrating that hypoxia inhibits osteogenesis and adipogenesis while promoting chondrogenesis (Kanichai et al, 2008;Cao, 2007;Hankenson et al, 2011;Peiffer et al, 2011;Hirao et al, 2006;Street et al, 2002;Gomillion and Burg, 2006;Hausman and Richardson, 2004). This computational model did not however propose a specific hypothesis for how environmental factors regulate the initiation and progression of chondrocyte hypertrophy and endochondral ossification, which is central to successful secondary fracture healing.…”