Perspective: Ultrastructural Origins of Bone Fragility

Crossmark: check for updates

Authors

  • Jitin Samuel Department of Mechanical Engineering, University of Texas at San Antonio, One UTSA Circle
  • Rohit Khanna Department of Mechanical Engineering, University of Texas at San Antonio, One UTSA Circle
  • Xiaodu Wang Department of Mechanical Engineering, University of Texas at San Antonio, One UTSA Circle

DOI:

https://doi.org/10.17140/ORHOJ-1-101

Keywords:

human bones, lamella

Abstract

Bone fragility fractures due to deteriorated tissue quality are a major healthcare con-cern in the healthcare of elderly who are at particularly high risk of bone fractures. Thus, iden-tifying and treating patients at risk is critical in sustaining a healthy life style for the elderly. Currently, bone mass or Bone Mineral Density (BMD) is commonly employed by physicians as a measure to predict the risk of such fractures. However, BMD is often a poor predictor of overall bone quality,1 showing that patients with healthy BMD levels may still be susceptible to fragility fractures.2,3 Hence, reliable prediction of bone fragility fractures requires understand-ing the underlying origins of bone fragility fracture beyond the qualitative estimation provided by BMD measurements.

References

Marshall D, Johnell O, Wedel H. Meta-analysis of how well measures of bone mineral density predict occurrence of osteopo-rotic fractures. BMJ. 1996; 312(7041): 1254-1259. doi: 10.1136/ bmj.312.7041.1254

Siris ES, Chen YT, Abbott TA. Bone mineral density thresh-olds for pharmacological intervention to prevent fractures. Arch Intern Med. 2004; 164(10): 1108-1112. doi: 10.1001/ archinte.164.10.1108

Sornay-Rendu E, Munoz F, Garnero P, Duboeuf F, Delmas PD. Identification of Osteopenic Women at High Risk of Frac-ture: The OFELY Study. J Bone Min Res. 2005; 20(10): 1813- 1819. doi: 10.1359/JBMR.050609

Fratzl P, Weinkamer R. Nature’s hierarchical materi-als. Prog Mater Sci. 2007; 52(8) 1263-1334. doi: 10.1016/j. pmatsci.2007.06.001

McNally EA, Schwarcz HP, Botton GA, Arsenault AL. A model for the ultrastructure of bone based on electron micros-copy of ion-milled sections. PLoS One. 2012; 7(1): e29258. doi: 10.1371/journal.pone.0029258

Schwarcz HP, McNally EA, Botton GA. Dark-field transmis-sion electron microscopy of cortical bone reveals details of ex-trafibrillar crystals. J Struct Biol. 2014; 188(3): 240-248. doi: 10.1016/j.jsb.2014.10.005

Almer JD, Stock SR. Micromechanical response of mineral and collagen phases in bone. J Struct Biol. 2007; 157(2): 365- 370. doi: 10.1016/j.jsb.2006.09.001

Samuel J, Park J-S, Almer J, Wang X. Effect of water on nanomechanics of bone is different between tension and com-pression. J Mech Behav Biomed Mater. 2016; 57: 128-138. doi: 10.1016/j.jmbbm.2015

Nair AK, Gautieri A, Chang S-W, Buehler MJ. Molecular me-chanics of mineralized collagen fibrils in bone. Nat Commun. 2013; 4: 1724. doi: 10.1038/ncomms2720

Gupta HS, Krauss S, Kerschnitzki M, et al. Intrafibril-lar plasticity through mineral/collagen sliding is the dominant mechanism for the extreme toughness of antler bone. J Mech Behav Biomed Mater. 2013; 28: 366-382. doi: 10.1016/j. jmbbm.2013.03.020

Luo Q, Nakade R, Dong X, Rong Q, Wang X. Effect of mineral-collagen interfacial behavior on the microdamage pro-gression in bone using a probabilistic cohesive finite element model. J Mech Behav Biomed Mater. 2011; 4(7): 943-952. doi: 10.1016/j.jmbbm.2011.02.003

Samuel J, Sinha D, Zhao JC-G, Wang X. Water residing in small ultrastructural spaces plays a critical role in the me-chanical behavior of bone. Bone. 59: 199-206. doi: 10.1016/j. bone.2013.11.018

Wang X, Xu H, Huang Y, Gu S, Jiang JX. Coupling effect of water and proteoglycans on the in situ toughness of bone. J Bone Miner Res. 2016. doi: 10.1002/jbmr.2774 Osteol Rheumatol Open J

Published

2025-09-10

How to Cite

Jitin Samuel, Rohit Khanna, & Xiaodu Wang. (2025). Perspective: Ultrastructural Origins of Bone Fragility. Osteology and Rheumatology, 1(1), 1–3. https://doi.org/10.17140/ORHOJ-1-101