The structural properties of normal and osteoporotic bone.

Although numerous advances have been made in the diagnosis and treatment of osteoporosis, only a fraction of those patients with osteoporosis who receive orthopaedic care are actually treated or referred for treatment of their osteoporotic condition. A review of the basic anatomic and structural properties of normal and osteoporotic bones and how these properties influence the load-carrying capacity of the skeleton is important. Anatomic and mechanical risk factors for osteoporosis form the basis for an appreciation of the clinical risk of fracture among patients. Because vertebral fractures are the most common fractures seen in patients with osteoporosis, attention is focused on the biomechanics of the vertebrae. This information should assist orthopaedic surgeons in the evaluation of patients who have or who are at risk for developing osteoporosis and prepare them for a variety of interventions, both pharmacologic and surgical, that can improve patient care.