Bone Remodeling
Like skin, bone forms before birth but continually renews itself thereafter.
Bone remodeling is a tightly regulated process that requires the resorption of old and
defective bone by osteoclasts, followed by the formation of new bone by osteoblasts.
Bone remodeling is a fundamental process by which the mammalian skeleton tissue is
continuously renewed to maintain the structural, biochemical and biomechanical integrity
of bone and to support its role in mineral homeostasis. The process of bone remodeling is
achieved by the cooperative and sequential work of groups of functionally and
morphologically distinct cells, termed basic multicellular units (BMUs) or bone
remodeling units (BRUs).
5% of the total bone mass in the body is being remodeled.
The renewal rate for compact bone tissue is about 4% per year and for spongy bone tissue
it is about 20% per year.
Remodeling can also take place at different rates in different regions of the body.
Example: the distal portion of the femur is replaced about every 4 months. Bone in the
certain areas of the shaft of the femur will not be replaced completely during an
individual’s life.
Remodeling may be triggered by factors such as: exercise, sedentary lifestyle, changes in
diet, and other several benefits.
Factors affecting Bone Growth and Bone Remodeling:
Normal bone metabolism – growth in the young and bone remodeling in the adult –
depends on several factors. These include adequate dietary intake of minerals and
vitamins, as well as sufficient levels of several hormones.
1. Minerals – large amounts of calcium and phosphorus are needed while bones are
growing, as are smaller amounts of magnesium, fluoride and manganese. These
minerals are also necessary during bone remodeling.
2. Vitamins – Vitamin A (stimulates activity of osteoblasts), Vitamin C (need for
synthesis of collagen, the main bone protein. Vitamin D (helps build bone by
increasing the absorption of calcium from foods in the gastrointestinal tract into
the blood. Vitamins K and B12 (also needed for synthesis of bone proteins.)
3. Hormones - the hormones most important to bone growth are the insulin-like
growth factors (IGFs), which are produced by the liver and bone tissue. It
stimulates osteoblasts, promote cell division at the epiphyseal plate and in the
periosteum and enhance synthesis of the proteins needed to build new bone. They
are also produced in response to the secretion of growth hormone (GH) from the
anterior lobe of the pituitary gland. Thyroid Hormones (T3 and T4) from the
thyroid gland also promote bone growth by stimulating osteoblasts. In Addition,
the hormone insulin from the pancreas promotes bone growth by increasing the
synthesis of bone proteins.
What does bone remodeling do?
Bone remodeling serves to adjust bone architecture to meet changing mechanical needs
and it helps to repair micro damages in bone matrix preventing the accumulation of
old bone. It also plays an important role in maintaining plasma calcium homeostasis. The
regulation of bone remodeling is both systemic and local.
Where does bone remodeling occur?
Bone remodeling (or bone metabolism) is a lifelong process where mature bone tissue
is removed from the skeleton (a process called bone resorption) and new bone tissue is
formed (a process called ossification or new bone formation). ... In the first year of life,
almost 100% of the skeleton is replaced.
Bone Remodeling Phases
bone remodeling occurs at many simultaneous sites throughout the body where bone is
experiencing growth, mechanical stress, microfractures, or breaks. About 20% of all bone
tissue is replaced annually by the remodeling process.
There are five phases in the bone remodeling process: ACTIVATION, RESORPTION,
REVERSAL, FORMATION, and QUIESCENCE. The total process takes about 4 to 8
months, and occurs continually throughout our lives.
PHASE PHASE EVENTS
I. ACTIVATION 1. Pre-osteoclasts are attracted to the remodeling sites.
2. Pre-osteoclasts fuse to form multinucleated osteoclasts.
II. RESPORPTION 3. Osteoclasts dig out a cavity, called a resorption pit, in spongy
bone or burrow a tunnel in compact bone.
4. Calcium can be released into the blood for use in various
body functions.
5. Osteoclasts disappear.
III. REVERSAL 6. Mesenchymal stem cells, pre-cursors to osteoblasts, appear
along the burrow or pit where they…
7. Proliferate (increase in numbers) and differentiate (change)
into pre- osteoblasts, then
IV. FORMATION 8. Mature into osteoblasts at the surface of the burrow or pit
9. Release osteoid at the site, forming a new soft
nonmineralized matrix.
10. The new matrix is mineralized with calcium and
phosphorous.
V. QUIESCENCE 11. Site, with resting lining cells, remains dormant until the next
cycle.
