ReviewBoneKEy reports2015
Bone microdamage, remodeling and bone fragility: how much damage is too much damage?
Review in BoneKEy reports, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
59 citing papers in PubMed, 1 synthesis or guideline pooled it, 141 citations in OpenAlex.
- Clinical implications of fracture severity risk with pioglitazone: a systematic review and meta-analysis of clinical randomized trials.Frontiers in pharmacology · 2025Pooled it
- Turning-Point Impact Compromises the Biomechanical Integrity of Cortical Bone During Oscillating Sawing.Annals of biomedical engineering · 2026Article
- Mechanism-Oriented Biomaterial Strategies for Bone Regeneration in BRONJ: From Pathological Barriers to Evidence-Matched Repair.Biomolecules · 2026Review
- The Role of Osteoblasts in Phenotypic Variability of Dominant Osteogenesis Imperfecta: Evidence from Patients and Murine Models.International journal of molecular sciences · 2025Article
- Review
- A mathematical model of metacarpal subchondral bone adaptation, microdamage and repair in racehorses.Journal of the Royal Society, Interface · 2025Article
- The Natural History of Bone Stress Injuries in Athletes: From Inception to Resolution.Sports medicine (Auckland, N.Z.) · 2025Review
- Multiscale Analysis Reveals Altered Characteristics in Femur and Mandible of Mice on a High Phosphate Diet.Calcified tissue international · 2025Article
- Microdamage in biological hard tissues and its repair mechanisms.Biomedical engineering online · 2025Review
- Runaway resorption of microcracks contributes to age-related hip-fracture patients.Scientific reports · 2025Article
- Advancement of bottom-up precipitation synthesis and applications of barium sulphate nanoparticles.RSC advances · 2025Review
- Association between sleep duration and hip fracture risk among the older adults: a cross-sectional study based on the NHANES.BMC musculoskeletal disorders · 2025Article
- Article
- Osteoarthritis: multitissue pathology, molecular mechanisms, clinical management, and emerging precision and regenerative therapies.Frontiers in pharmacology · 2025Review
- Article
- Interfaces between Cranial Bone and AISI 304 Steel after Long-Term Implantation: A Case Study of Cranial Screws.ACS biomaterials science & engineering · 2024Article
- Histological and Histopathological Features of the Third Metacarpal/Tarsal Parasagittal Groove and Proximal Phalanx Sagittal Groove in Thoroughbred Horses with Racing History.Animals : an open access journal from MDPI · 2024Article
- Effects of long-term voluntary wheel running and selective breeding for wheel running on femoral nutrient canals.Journal of anatomy · 2024Article
- Approaching virtual osteoid volume estimation and in-depth tissue characterization in patients with tumor-induced osteomalacia.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024Article
- Intracortical remodelling increases in highly loaded bone after exercise cessation.Journal of anatomy · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
Microdamage resulting from fatigue or 'wear and tear' loading contributes to bone fragility; however, the full extent of its influence is not completely understood. Linear microcracks (∼50-100 μm) and diffuse damage (clusters of sublamellar-sized cracks) are the two major bone microdamage types, each with different mechanical and biological consequences. Healthy bone, due to its numerous microstructural interfaces and its ability to affect matrix level repair, deals effectively with microdamage. From a material standpoint, healthy bone behaves much like engineering composites like carbon-fiber reinforced plastics. Both materials allow matrix damage to form during fatigue loading and use microstructural interfaces to dissipate energy and limit microcrack propagation to slow fracture. The terms fracture toughness and 'toughening mechanism', respectively, describe mechanical behavior and microstructural features that prevent crack growth and make it harder to fracture a material. Critically, toughness is independent of strength. In bone, primary toughening features include mineral and collagen interfaces, lamellae and tissue heterogeneity among osteons. The damage tolerance of bone and other composites can be overcome with sustained loading and/or matrix changes such that the microstructure no longer limits microcrack propagation. With reduced remodeling due to aging, disease or remodeling suppression, microdamage accumulation can occur along with loss of tissue heterogeneity. Both contribute additively to reduced fracture toughness. Thus, the answer to the key question for bone fragility of how much microdamage is too much is extremely complex. It ultimately depends on the interplay between matrix damage content, internal repair and effectiveness of matrix-toughening mechanisms.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.