Perspectives: a proposed general model of the "mechanostat" (suggestions from a new skeletal-biologic paradigm).

This provisional general model for the skeleton's mechanostat spans the biologic "distance" between the organ and macromolecule. It could apply to bone, cartilage and fibrous tissue, and to bones, joints, ligaments and other organs made wholly or in part from the basic tissues. It suggests where small things such as a cytokine effect on some cell should fit in the overall scheme of skeletal physiology. It proposes that interlocking negative feedback loops provide mechanical-usage-dedicated message traffic routes on which nonmechanical agents could act to optimize or impair postnatal skeletal adaptations to varied mechanical and nonmechanical challenges, and treatments of disease too. It suggests that future research must try to understand the mechanostat's cell- and molecular-biologic roots.