BASICS OF BONE-DANCEL …………………………………………..

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1. BASICS OF BONE
KAREN A.DANCEL, M.D.
Basic of Orthopaedic Science by Manoj Ramachandran
Netter’s Concise Orthopaedic Anatomy Second Edition

2. Function
01
Structure
02
Blood Supply
03
Bone Metabolism
04
CONTENTS

3. What is the
structure of
Bone?

4. 3 Main Functions:

●Reservoir of Calcium and
Phosphate
●Hematopoiesis
●Protective and mechanical
Basic of Orthopaedic Science by Manoj Ramachandran

5. Basic of Orthopaedic Science by Manoj Ramachandran
Netter’s Concise Orthopaedic Anatomy Second Edition

6. Basic of Orthopaedic Science by Manoj Ramachandran
Netter’s Concise Orthopaedic Anatomy Second Edition

7. ]
What cells are found in bone?
What are their functions ?

8. Basic of Orthopaedic Science by Manoj Ramachandran
Netter’s Concise Orthopaedic Anatomy Second Edition

9. What does
matrix of
bone contain?

10. Basic of Orthopaedic Science by Manoj Ramachandran
Netter’s Concise Orthopaedic Anatomy Second Edition

11. Basic of Orthopaedic Science by Manoj Ramachandran
Netter’s Concise Orthopaedic Anatomy Second Edition

12. ]
How does remodeling of
bone occur ?

13. Basic of Orthopaedic Science by Manoj Ramachandran
Netter’s Concise Orthopaedic Anatomy Second Edition

14. Basic of Orthopaedic Science by Manoj Ramachandran
Netter’s Concise Orthopaedic Anatomy Second Edition










Nutrient Artery (high
pressure system)

• Branch from systemic
arteries, enter
the diaphyseal cortex
through the
nutrient foramen, enter the
medullary
canal, and branch into
ascending and
descending arteries

Further branch into arterioles
in the
endosteal cortex, which
enables
blood supply to at least the
inner
two-thirds of the mature
diaphyseal
cortex via the haversian
system

15. Basic of Orthopaedic Science by Manoj Ramachandran
Netter’s Concise Orthopaedic Anatomy Second Edition









Metaphyseal-epiphyseal
system








• Arises from the periarticular
vascular
plexus (e.g., geniculate
arteries)

16. Basic of Orthopaedic Science by Manoj Ramachandran
Netter’s Concise Orthopaedic Anatomy Second Edition










Periosteal system (Low
pressure system)







• Consists mostly of
capillaries that
supply the outer third (at
most) of the
mature diaphyseal cortex
• BP in the periosteal system
is low.

17. Basic of Orthopaedic Science by Manoj Ramachandran
Netter’s Concise Orthopaedic Anatomy Second Edition










Periosteal system (Low
pressure system)







• Consists mostly of
capillaries that
supply the outer third (at
most) of the
mature diaphyseal cortex
• BP in the periosteal system
is low.

18. How is calcium
regulated in the
body ?
What is the
contribution of
bone?

21. Peak bone mass
• Believed to occur between 16 and 25 years of age

• Higher in men and in African Americans

• After peak, bone loss occurs at a rate of 0.3%–0.5% per year

• Rate of bone loss is 2%–3% per year in untreated women during
the sixth through tenth years after menopause.

• Affects trabecular more than cortical bone

• Increase in trabecular rods results in
increased anisotropy.
Basic of Orthopaedic Science by Manoj Ramachandran

22. Basic of Orthopaedic Science by Manoj Ramachandran
• Cortical bone becomes thinner and intracortical porosities
increase

• Cortical bone becomes more brittle,less strong and less stiff

• Long bones have greater inner and outer
diameters

23. Basic of Orthopaedic Science by Manoj Ramachandran
Bone loss
• Occurs at the onset of menopause when both bone formation and
resorption are accelarated

• A net negative change in calcium balance: menopause decreases
intestinal absorption and increases urinary excretion of calcium

• Both urinary hydroxyproline and pyridinoline cross-links are elevated
when one resoration occurs

• Serum alkaline phosphatase level is elevated when bone formation is
increased

24. THANK YOU