title: The role of adaptive bone formation in the etiology of stress fracture.
abstract: Stress fractures are common injuries with load-bearing activities. Stress fractures have been reported in the scientific literature for over a century; however, the etiology continues to be investigated with important distinctions made between the contributions of the tissue-level processes of bone remodeling and modeling. In response to novel repetitive loading, increased bone remodeling may serve to replace fatigue-damaged bone while at the same time creating temporary porosity. Much attention has been given to the role of remodeling in the etiology of stress fracture; however, the role of bone modeling has received less attention. Modest increases in modeling, via bone formation on the periosteal surface of long bones in response to mechanical loading, greatly increases the fatigue resistance of bone. Thus, enhancing this adaptive bone formation is a promising target for stress fracture prevention, and a focus on adaptive bone formation may reveal novel risk factors for stress fracture.
authors: 1 Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, USA.
authors: Julie M
authors: JM
authors: Hughes
authors: 2 Endocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA.
authors: Kristin L
authors: KL
authors: Popp
authors: 3 The Warrior Health Research Institute of Military Physiology, Israel Defense Forces' Medical Corps.|4 Heller Institute of Medical Research, Sheba Medical Center, Tel-Hashomer 52621, Israel.
authors: Ran
authors: R
authors: Yanovich
authors: 2 Endocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA.|5 Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.|6 Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA 02215, USA.
authors: Mary L
authors: ML
authors: Bouxsein
authors: 1 Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, USA.
authors: Ronald W
authors: RW
authors: Matheny
mesh_terms: D000818:Animals; D016723:Bone Remodeling; D015775:Fractures, Stress / Q000209:etiology*; D006801:Humans; D010012:Osteogenesis
keywords: NSAIDs; Stress fracture; bone formation; bone modeling; bone remodeling; military