A uniform strain criterion for trabecular bone adaptation: do continuum-level strain gradients drive adaptation?

In this paper, it is postulated that the apparent density of trabecular bone adapts so that continuum-level strains within the bone are uniform and, as a consequence, spatial strain gradients within the bone/marrow continuum are minimized. The feasibility of a uniform strain criterion was tested using computational finite-element analysis of the proximal femur. We demonstrated that (1) this criterion produced a realistic apparent density distribution in the proximal femur, (2) the solutions for apparent density were convergent and unique, (3) predicted apparent densities compared well to experimental measurements, and (4) strain gradients within the bone/marrow continuum were reduced substantially. Thus, a possible goal of trabecular bone adaptation may be the reduction of strain gradients within the bone/marrow continuum. Osteocytes within the bone tissue and bone cells on the surface of a trabeculum are mechanosensitive and play a role in bone adaptation. In addition, the bone marrow is rich in osteoprogenitor cells near the bone surface that are mechanosensitive. Strain gradients within bone/marrow continuum cause pressure gradients in the marrow, causing extracellular fluid flow which could stimulate osteoprogenitor cells and contribute to bone adaptation.