Ah&act-It is generally accepted that the strength and stiffness of trabecular bone is strongly affected by trabecular microstructure. It has also been hvoothesized that stress induced adaptation of trabecular bone is affected by trabecular tissue level stress and;& strain. At this time, however, there is no generally accepted (or easily accomplished) technique for predicting the effect of microstructure on trabecular bone apparent stiffness and strength or estimating tissue level stress or strain. In this paper, a recently developed mechanics theory specifically designed to analyze microstructured materials, called the homogenization theory, is presented and applied to analyze trabecular bone mechanics. Using the homogenization theory it is possible to perform microstructural and continuum analyses separately and then combine them in a systematic manner. Stiffness predictions from two different microstructural models of trabecular bone show reasonable agreement with experimental results, depending on metaphyseal region, (R">0.5 for proximai humerus specimens, R* ~0.5 for distal femur and proximal tibia specimens). Estimates of both microstructural strain energy density (SED) and apparent SED show that there are large differences (up to 30 times) between apparent SED (as calculated by standard continuum finite element analyses) and the maximum microstructural or tissue SED. Furthermore, a strut and spherical void microstructure gave very different estimates of maximum tissue SED for the same bone volume fraction (BV/TV). The estimates from the spherical void microstructure are between 2 and 20 times greater than the strut microstructure at lo-20% W/TV INTRODUCTION Stress and strain fields in individual trabeculae are determined by both overall metaphyseal geometry and the microstructural organization of a local region of trabeculae. However, directly calculating stress and strain fields for each trabecula of a whole metaphysis is impossible with current computational technology. Current techniques for determining trabecular stress have focused on either analyzing very small regions of bone with a limited number of trabeculae, or analyzing a much larger region of bone assuming it to be a solid with apparent material properties. Neither technique provides direct information about trabecular tissue stresses and strains in an entire metaphyseal region. The homogenization theory is a recently developed method which provides a systematic way to combine stress analyses at the metaphyseal and individual trabecula level. This paper presents the initial application of homogenization theory to the study of trabecular bone mechanics.Microstructural analyses are generally used to predict apparent moduli and stress distributions within representative pieces of a given microstructure. These analyses assume that the whole microstructure within a material is constructed by repeating the representative piece analyzed. This type of analysis is quite Received infinalform 14 February 1991.