Abstract

In consonance with the traditional spirit of our studies, skeletal research is being pro¬gressively focused on the structural-biome¬chanical analysis of bone and the muscle-bo¬ne interactions. In this article, the CEMFoC’s members summarize their original findings in bone biomechanics and their potential clinical applications. These findings provided eviden¬ce supporting two fundamental hypotheses, namely, A. bones constitute resistive struc¬tures, which are biologically servo-controlled (‘Bones tend to maintain a safety factor which allows the body to function normally avoiding fractures’ – the ‘Utah paradigm’), and B. the interactions of bones with their mechanical environment mainly are determined by the contraction of local muscles - ‘bone-muscle units’), and are subordinated to the control of the metabolic environment (‘Bones are what muscles wish them to be, provided that hormones allow for it’). The achievements in the field are presented in a chronological and didactical sequence concerning the general knowledge in Osteology and the development of novel resources for non-invasive diagno¬sis of bone fragility, aiming to distinguish between osteopenias and osteoporosis and the ‘mechanical’ and ‘metabolic’ etiology of these conditions. Finally, the integrated new knowledge is presented as supporting for a proposed diagnostic algorithm for osteope¬nias and osteoporosis. In general terms, the article highlights the dynamic evaluation of the musculoskeletal system as a whole, ope¬ning a new diagnostic field for a personalized evaluation of the patients affected by a bone-weakening disease, based on functional and biomechanical criteria.
Key words: bone biomechanics, osteopenia, osteoporosis, bone densitometry, bone tomo¬graphy, bone/muscle interactions, sarcopenia, dynamometry.