Bone remodeling: A review of the bone microenvironment perspective for fragility fracture (osteoporosis) of the hip.

Bone remodeling is an active process throughout the skeleton. The concept of bone turnover surface has been developed and reported in the peer reviewed literature as the quotient of formation surface/resorption surface and is significantly lower in hip fracture. It is necessary to identify the molecular drivers of these changes in bone turnover. Factors that have been strongly implicated in bone metabolism are therefore divided into three categories, "Vascular", "Anabolic" and "Catabolic". Further data is required from the bone tissue-level microenvironment, of fragility fracture patients, on the variation in molecular signals, and the associated changes in bone structure and remodeling.