Biological basis of bone strength: Anatomy, physiology and measurement

Nicolas H. Hart, Robert U. Newton, Jocelyn Tan, Timo Rantalainen, Paola Chivers, Aris Siafarikas, Sophia Nimphius

Research output: Contribution to journalReview articlepeer-review

36 Citations (Scopus)


Understanding how bones are innately designed, robustly developed and delicately maintained through intricate anatomical features and physiological processes across the lifespan is vital to inform our assessment of normal bone health, and essential to aid our interpretation of adverse clinical outcomes affecting bone through primary or secondary causes. Accordingly this review serves to introduce new researchers and clinicians engaging with bone and mineral metabolism, and provide a contemporary update for established researchers or clinicians. Specifically, we describe the mechanical and non-mechanical functions of the skeleton; its multidimensional and hierarchical anatomy (macroscopic, microscopic, organic, inorganic, woven and lamellar features); its cellular and hormonal physiology (deterministic and homeostatic processes that govern and regulate bone); and processes of mechanotransduction, modelling, remodelling and degradation that underpin bone adaptation or maladaptation. In addition, we also explore commonly used methods for measuring bone metabolic activity or material features (imaging or biochemical markers) together with their limitations.

Original languageEnglish
Pages (from-to)347-371
Number of pages25
JournalJournal of Musculoskeletal Neuronal Interactions
Issue number3
Publication statusPublished - Sept 2020


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