Adaptation of growing bone to altered mechanical load : morphological change, structural strength and gene expression

Abstract

Osteoporosis, a condition characterised by a loss of bone mass, is of increasing clinical interest in an aging population. Bone formation and growth are controlled by genetic, hormonal and biomechanical factors. This multifactorial regulation is present in utero with mechanical loading critical in regulating skeletogenesis. After birth, growth and ossification are strongly influenced by physical activity and externally applied forces. Clinically, reduced loading may occur due to bed-rest, paralysis or stress shielding around implants while overloading may lead to differential growth and skeletal asymmetry.