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The Journal of Bone and Joint Surgery, Vol 66, Issue 3 397-402, Copyright © 1984 by Journal of Bone and Joint Surgery, Inc
Regulation of bone formation by applied dynamic loads
CT Rubin and LE Lanyon
In studies on a functionally isolated avian-bone preparation to which
external loads could be applied in vivo, we determined the following
information. Removal of load-bearing resulted in substantial remodeling
endosteally, intracortically, and, to a lesser extent, periosteally. Since
the balance of this remodeling was negative, bone mass declined. It
therefore appears that functional load-bearing prevents a remodeling
process that would otherwise lead to disuse osteoporosis. Four consecutive
cycles a day of an externally applied loading regimen that engendered
physiological strain magnitudes but an altered strain distribution
prevented remodeling and was thus associated with no change in bone mass. A
small exposure to, or the first effect of, a suitable dynamic strain
regimen appears to be sufficient to prevent the negatively balanced
remodeling that is responsible for disuse osteoporosis. Thirty-six
0.5-hertz cycles per day of the same load regimen also prevented
intracortical resorption but was associated with substantial periosteal and
endosteal new-bone formation. Over a six-week period, bone-mineral content
increased to between 133 and 143 per cent of the original value.
Physiological levels of strain imposed with an abnormal strain distribution
can produce an osteogenic stimulus that is capable of increasing bone mass.
Neither the size nor the character of the bone changes that we observed
were affected by any additional increase in the number of load cycles from
thirty-six to 1800. Clinical Relevance: The results of this experiment must
be considered in relation to the type and duration of the non-physiological
loads that were imposed.(ABSTRACT TRUNCATED AT 250 WORDS)
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