A Review

on

Bone as a living dynamic tissue

Submitted to:
Dr. Manoj Kumar Shah
Department of Surgery
Rampur Campus, Rampur

Sumbitted by:
Suraj Subedi
Roll no : 29
B. V. Sc & A.H. 8th Sem
Rampur Campus, Rampur

Dec, 2010
Introduction
Bones are rigid organs that form part of the endoskeleton of vertebrates. They function to
move, support, and protect the various organs of the body, produce red and white blood cells and store
minerals. Bone tissue is a type of dense connective tissue. Bones come in a variety of shapes and have
a complex internal and external structure they are lightweight, yet strong and hard, in addition to
fulfilling their many other functions. One of the types of tissue that makes up bone is the mineralized
osseous tissue, also called bone tissue, that gives it rigidity and a honeycomb-like three-dimensional
internal structure. Other types of tissue found in bones include marrow, endosteum and periosteum,
nerves, blood vessels and cartilage.
Bone is a dynamic, living tissue; not the hard, dry, lifeless frame. About 30% of bone is living
tissue, cells, and blood vessels. The blood vessels go in and out of the bone carrying oxygen and
nutrients, and taking away wastes. Bones contain marrow which produces red blood cells and white
blood cells. Bones have nerves that can feel pressure and pain. About 45% of bone is mineral
(primarily calcium and phosphorus), giving bone its hardness and rigidity and storing these minerals
for future use. Bone releases some of this mineral when other body parts, such as nerves, may need
them. Bone also contains the proteins, collagen and elastin. Finally, about 25% of bone is made up of
water.

Bone tissue consists of compact bone (cortical or solid bone) and spongy bone (trabecular or
cancellous bone). Compact bone is made up of structural units called Haversian systems. The system
is composed of concentrically arranged layers of hard inorganic matrix surrounding a microscopic
central Haversian canal. Blood vessels and nerves pass through the canal. Spongy bone is like a
network of hardened bars with spaces between them filled with marrow.

Bone tissue is made and maintained by several types of cells: osteoblasts, osteocytes, and
osteoclasts. Osteoblasts make new bone by hardening the protein, collagen, with minerals. Osteocyctes
maintain bone, passing nutrients and wastes back and forth between the blood and bone tissues.
Osteoclasts destroy bone, releasing minerals into the blood. All through life, bone is continually being
reconstructed and reshaped. A young animal has very soft bones made up of cartilage. As it grows, the
cartilage is replaced by calcium (ossification). When it reaches the maturity, the bones stop getting
longer or bigger, but there is still a lot of growing going on. Old bone cells dissolve and are replaced
by new bone cells. Because bone keeps growing, the body is able to repair any breaks that may occur.

Classification of Bone
On the basis of their naked eye appearance in regard to shape, size and structure, the bone has been
generally classified into following types.
 Long Bones: these are the long hollow cylindrical types of bones found in the limbs. These are
weight bearing bones and act as levers. A long bone has a shaft and two expanded ends. The
shaft contains a large medullary cavity. These bones ossify in cartilage. e.g. Femur, Humerus
Modified long bones – small long bones like clavicle in dogs, rabbit and fowl do not possess
medullary cavity and therefore considered as modified long bones. Miniature long– These are long
bones but small in size. E.g. metacarpels of dogs
 Short bones: these are small pieces of partially smooth surfaced bones mainly found in the
joints and help in their mobility. Most of these bones present six surfaces. These are mainly
composed of spongy substance with a layer of cortical compact bone. e.g. carpal bones
 Flat bones: These are flat irregular boney plates designed for enclosing cavities which contain
important organs of the body. Flat bones are composed of two plates of compact bone with
intervening spongy bone. e.g. scapula, some cranial bones of skull.
 Irregular bones: These are also small bones with rough irregular surfaces generally found in the
mid-line of the skeleton. Their so many projections help in the attachment of the various
muscles. They are composed of spongy substance with the thin covering of compact
substances. e.g. vertebra
  Pneumatic bones: Some long bones of birds have cavities inside their bodies which
accommodate air sacs through pneumatic foramen in living conditions. e.g. humerus of fowl.
Bones situated closely to the nasal cavity which contain air-filled cavities are also considered
as pneumatic bones. e.g. frontal bone, maxilla and ethmoid.
 Sesamoid bones: These are small seasame (seed) like bones develop within the tendon. They
work as pully to avoid friction. e.g Patella.
 Visceral bones: These are fouund in the ciscera of some animals and birds. e.g. os penis in dog,
os cordis in ruminants, os opticus in some fowl etc.
Functions of bone
Mechanical
• Protection : Bones can serve to protect internal organs, such as the skull protecting the brain or
the ribs protecting the heart and lungs.
• Shape : Bones provide a frame to keep the body supported.
• Movement : Bones, skeletal muscles, tendons, ligaments and joints function together to
generate and transfer forces so that individual body parts or the whole body can be manipulated
in three-dimensional space. The interaction between bone and muscle is studied in
biomechanics.
• Sound transduction : Bones are important in the mechanical aspect of overshadowed hearing.
Synthetic
• Blood production : The marrow, located within the medullary cavity of long bones and
interstices of cancellous bone, produces blood cells in a process called haematopoiesis.
Metabolic
• Mineral storage : Bones act as reserves of minerals important for the body, most notably
calcium and phosphorus.
• Growth factor storage : Mineralized bone matrix stores important growth factors such as
insulin-like growth factors, transforming growth factor, bone morphogenetic proteins and
others.
• Fat Storage : The yellow bone marrow acts as a storage reserve of fatty acids.
• Acid-base balance : Bone buffers the blood against excessive pH changes by absorbing or
releasing alkaline salts.
• Detoxification : Bone tissues can also store heavy metals and other foreign elements, removing
them from the blood and reducing their effects on other tissues. These can later be gradually
released for excretion.
• Endocrine organ : Bone controls phosphate metabolism by releasing fibroblast growth factor -
23 (FGF-23), which acts on kidneys to reduce phosphate reabsorption. Bone cells also release a
hormone called osteocalcin, which contributes to the regulation of blood sugar (glucose) and
fat deposition. Osteocalcin increases both the insulin secretion and sensitivity, in addition to
boosting the number of insulin-producing cells and reducing stores of fat.
Bone Formation in the Body
The process of bone formation is known as ossification. Calcification is an event in the process of
ossification. There are two types of ossification.

a) Intramembranous or mesenchymal ossification

b) Intracartilagenous of endochondral ossification

A) Intramembranous ossification mainly occurs during formation of the flat bones of the skull but
also the mandible, maxilla, and clavicles; the bone is formed from connective tissue such as
mesenchyme tissue rather than from cartilage. The steps in intramembranous ossification are:
i. Development of ossification center: At a point (center of ossification) osteoblasts are
differentiated from the mesenchymal cells. A mesh-work of collagen fibers produced by the
osteoblasts appear between the cells. It become vascularized by capillary network. The
osteoblasts produce other organic intracellular substances like mucoprotein, glycoprotein,
mucopolysaccharide etc. The organic non-calcified matrix is called osteoid.
ii. Calcification: The martix is calcified by osteoblasts.
iii.Formation of trabeculae : Few osteoblasts become entrapped by the surrounding matrix and are
transformed in radiating manner from the center. Thus trabeculae are formed between the
cells. The trabeculae join each other to form cancellous bone. The osteoblasts surrounding the
bony spicules deposit more bones to the free ends and sides and thus calcification is spread
and the bone becomes compact.
iv. Development of periosteum : The periosteum is developed from the condensation of
mesenchyme.
B) Endochondral Ossification occurs where a cartilage precursor of the bone is formed during
embryonic development and then, starting from the beginning of the fetal period ossification begins in
cartilage.
It is carried out by replacing hyaline cartilage. Steps of endochondral ossification are:
• Development of cartilage model
• Growth of cartilage model
• Development of the primary ossification center
• Development of the secondary ossification center
• Formation of articular cartilage and epiphyseal plate
The process occurs in various stages as:
Stage I
A cartilaginous model is formed by the condensation of mesenchymal tissue. A perichondrium
appears around the cartilage. The cartilage cells (chondroblasts) at the mid-section of the model
proliferate by mitosis and are arranged in the rows towards the ends. They mature and get
hypertrophied. The hypertrophied cells produce alkaline phosphatase and precipitate calcium salt at
the matrix. The surrounding calcification cause death of the cartilage cells and thereby forms spaces –
the primary areolae. This zone is known as primary ossification center. At the same time osteoblasts
appear at the inner layer of perichondrium and form subperiosteal collar bone around the primary
ossification center. The perichondrium is then called periosteum.
Stage II
At this stage, the collar bone is eroded by the increased activity of the subpeiosteal osteoclasts
and the periosteal buds containing osteoblasts, osteoclasts and blood vessels enter into the primrary
ossification center. The osteoclasts absorb the irregular clacified mass and form secondary large
areolae. These secondary areolae lead to the formation of marrow cavity which subsequently becomes
filled up by bone marrow.
Stage III
It is the true stage of bone formation. In this stage, the osteoblasts appear and lay down
lamellated bone. Subsequently a number of longitudional groove appear on the outer surface of bony
lamella. The ridges of each groove proliferate and enclose a small bood vessels and groove develops
into tunel. The lining osteoblasts of the tunnel convert the tunnel into haversian system by the
proliferation and differentiation into osteocytes. The whole process is repeated again and again and the
ossification extends longitudionally. Secondary ossification centres called the epiphysis appear at the
ends of the cartilagenous model and present at the time of birth. At the ends of long bones, a layer of
cartilage doesnot ossify and remain as articular cartilage throughout life. In the growth phase, a
portion of of the cartilagenous model remains as epiphyseal cartilage between the epiphysis and
diaphysis. This epiphyseal cartilage helps longitudional growth of the bone and is replaced totally by
the bone when the growth is complete. The width of bone increases by the deposition of
subperiosoteal membrane bone.
Cartilage is converted to bone at the growth plate in 5 stages.
1. Hypertrophy – the cartilage grows rapidly and the chondrocytes line up in columns that point
in the direction of growth.
2. Calcification of cartilage matrix
3. Death of chondrocytes.
4. Replacement of calcified cartilage by bone.
5. Remodelling of the new bone
 Macrostructure of Bones
• Consist of cortical bone, trabecular bone, and marrow
• Distribution of each depends on anatomical location
• Long bones
• Tubular in shape
• Length of bone greater than breadth
• Some long bones may actually be short
• Consist of a shaft and two enlarged, curved ends
• Shaft of bone consists of cortical bone surrounding medullary cavity (filled with
marrow) - diaphysis
• Ends of bone consist of cortical shell of bone surrounding trabecular bone
• Examples: Femur, Tibia and fibula, Humerus, Radius and ulna
• After birth, longitudinal growth of long bones occurs in two regions
• Epiphysis -
• Highly trabecular region at most proximal and distal ends of long bone
• Metaphysis -
• Highly trabecular region at proximal and distal end of diaphysis
• The epiphysis and methaphysis are separated by epiphyseal cartilage plate
(growth plate) that ossifies when growth has stopped
• Throughout life, radial growth can occur at two surfaces
• Periosteum -
• Outer surface of bone, through which blood supply reaches the bone
• Endosteum -
• Inner surface of bone, in contact with medullary canal
• Bone can be deposited or resorbed at these two surfaces
• Resorbtion can occur in any region of the bone, typically followed by deposition
of bone in the same region -- termed remodeling
 • Short bones
• Cuboidal in shape
• Consist of cortical shell with inner trabecular core
• Exist only in the wrist and foot
• Carpal and tarsal bones
• Flat bones
• Consist of two plates of cortical bone with trabecular tissue in between
• Generally curved rather than flat
• Examples:
• Calvaria (top of skull)
• Sternum (breast bone)
• Scapula (shoulder blade)
• Ribs
• Irregular bones
• Various shapes
• Composition depends on bone
• Examples:
• Facial bones
• Vertebrae (bones of spine)
• Consist of thin cortical shell surrounding trabecular core

a) Epiphysis (end) and Epiphyseal line: The epiphysis is the

end of the long bone. Externally it has a thin layer of compact
bone while inner it is cancellous. Epiphysis is caped with
articular cartilage.

b) Diaphysis (shaft): Has compact bone with a central cavity. It

resists bending forces.

c) Articular Cartilage: is found in the end of long bones. It is

smooth slippery and bloodless.

d) Periosteum: It is a fibrous, vascular, sensitive life support

covering or sheath of the bone. It provides nutrient rich blood for
bone cells and also a source of bone-developing cells during
growth or after a fracture.

e) Cancellous or spongy bone and marrow: It appears as a tiny

beam of bones arranged like a lattice. Red marrow packs the
space between beams of some epiphysis as well as elsewhere.

f) Compact Bone: A dense bone found in diaphysis. It is

arranged in concentric layers.

g) Medullary cavity: Medullary cavity of diaphysis serves to

tighten bone and provides space for its marrow.

h) Nutrient Artery: Each long bone contains an oblique tunnel

in its shaft for the passage of a nutrient artery which supplies the
shaft.
Compact (cortical) bone

The hard outer layer of bones is composed of compact bone tissue, so-called due to its minimal
gaps and spaces. Its porosity is 5-30%. This tissue gives bones their smooth, white, and solid
appearance, and accounts for 80% of the total bone mass of an adult skeleton. Compact bone may also
be referred to as dense bone.
Trabecular bone/ Spongy bone
Filling the interior of the bone is the trabecular bone tissue (an open cell porous network also
called cancellous or spongy bone), which is composed of a network of rod- and plate-like elements
that make the overall organ lighter and allow room for blood vessels and marrow. Trabecular bone
accounts for the remaining 20% of total bone mass but has nearly ten times the surface area of
compact bone. Its porosity is 30-90%.If for any reason there is an alteration in the strain to which the
cancellous is subjected, there is a rearrangement of the trabeculae.
Compact bone is composed of cylindrical
structures called osteons or Haversian systems. An osteon
consists of concentric lamellae of bone matrix, mainly
collagen fibres, surrounding a central canal called the
Haversian canal, which contains small blood vessels and
nerves. The long axis of osteons is usually parallel to the
long axis of the bone. The collagen fibres within any one
lamella are generally parallel with one another, but the
collagen fibres in the different lamellae of an osteon are
oriented at different angles. This increases the strength of
the osteon. Canals called Volkmann’s canals link the
Haversian canals of different osteons with one another and
with the marrow cavity. They provide the major route for
blood vessels from the marrow cavity to the Haversian
canals of osteons.
Between the lamellae of an osteon are lacunae
containing bone cells called osteocytes. Canaliculi connect
the lacunae with one another and with the Haversian
canal. The canaliculi contain the processes of the
osteocytes, which communicate with one another via gap
junctions. Thus nutrients and other substances, such as hormones, can pass from blood vessels in the
Haversian canal to distant osteocytes via a sort of bucket brigade. Osteocytes can be involved in both
bone deposition and bone resorption.
In addition to the lamellae of osteons, lamellae not belonging to any osteon can be seen in
compact bone. These are called interstitial lamellae and are the remnants of previous osteons. They
reflect the fact that bone is not static but is constantly being remodelled. In addition, the inner and
outer surfaces of long bone have lamellae that run the length of the shaft. They are called, respectively,
the inner and outer circumferential lamellae.
Spongy bone is composed of bone spicules, also called trabeculae, of varying shapes and sizes.
The spaces between the spicules are filled with marrow. The composition of spongy bone (cells and
matrix) is the same as that of compact bone. In spongy bone, however, the lamellae of collagen are not
arranged concentrically around a central canal, but run parallel to one another. Osteocytes sit in
lacunae between lamellae.
The microscopic difference between compact and cancellous bone is that compact bone
consists of haversian sites and osteons, while cancellous bones do not. Also, bone surrounds blood in
the compact bone, while blood surrounds bone in the cancellous bone.
Cellular structure
There are several types of cells constituting the bone. These are:
• Osteoprogenitor cells (periosteal and endosteal): Just as cartilage is surrounded by a
perichondrium, bone is surrounded by a periosteum of dense connective tissue. As in the
perichondrium, the periosteum has two layers: an outer fibrous layer with typical fibroblasts,
and an inner cellular layer, which contains osteoprogenitor cells. The osteoprogenitor cells in
this location are called periosteal cells. They are capable of giving rise to osteoblasts, which
secrete the extracellular matrix of bone.
The marrow surface of compact bone, and the spicules of spongy bone, are lined by an
(often single) layer of cells called
the endosteum (endosteal cells).
Like the periosteal cells, these
endosteal cells are also
osteoprogenitor cells, capable of
becoming osteoblasts. (The two
names periosteal cells and
endosteal cells refer to their
different locations, both function
as osteoprogenitor cells).
• Osteoblasts are mononucleate
bone forming cells that descend
from osteoprogenitor cells. They
are located on the surface of
osteoid seams and make a protein
mixture known as osteoid, which
mineralizes to become bone. The
osteiod seam is a narrow region of
newly formed organic matrix, not
yet mineralized, located on the
surface of a bone. Osteoid is
primarily composed of Type I collagen. Osteoblasts also manufacture hormones, such as
prostaglandins, to act on the bone itself. They robustly produce alkaline phosphatase, an
enzyme that has a role in the mineralisation of bone, as well as many matrix proteins.
Osteoblasts are the immature bone cells.
• Bone lining cells are essentially inactive osteoblasts. They cover all of the available bone
surface and function as a barrier for certain ions.
• Osteocytes originate from osteoblasts that have migrated into and become trapped and
surrounded by bone matrix that they themselves produce. The spaces they occupy are known as
lacunae. Osteocytes have many processes that reach out to meet osteoblasts and other
osteocytes probably for the purposes of communication. Their functions include to varying
degrees: formation of bone, matrix maintenance and calcium homeostasis. Osteocytes can both
secrete and resorb matrix. They have also been shown to act as mechano-sensory receptors —
regulating the bone's response to stress and mechanical load. They are mature bone cells.
• Osteoclasts are the cells responsible for bone resorption (remodeling of bone to reduce its
volume). Osteoclasts are large, multinucleated cells located on bone surfaces in what are called
Howship's lacunae or resorption pits. These lacunae, or resorption pits, are left behind after the
breakdown of the bone surface. Because the osteoclasts are derived from a monocyte stem-cell
lineage, they are equipped with phagocytic-like mechanisms similar to circulating
macrophages. Osteoclasts mature and/or migrate to discrete bone surfaces. Upon arrival, active
enzymes, such as tartrate resistant acid phosphatase, are secreted against the mineral substrate.
Molecular structure
• Mineral phase (69 wt%):
• Majority is hydroxyapatite [HA] (calcium phosphate)
• Also citrate, carbonate, fluoride, and hydroxyl ions
• Organic phase (22 wt%)
• Collagen (90-96 wt%)
• Cellular components (osteoclasts, osteoblasts, osteocytes)
• Water (9 wt%)
1) Matrix
The majority of bone is made of the bone matrix. It has inorganic and organic parts. Bone is
formed by the hardening of this matrix entrapping the cells. When these cells become entrapped
from osteoblasts they become osteocytes.
Inorganic
The inorganic composition of bone (bone mineral) is formed from carbonated hydroxyapatite
(Ca10(PO4)6OH2) with lower crystallinity. The matrix is initially laid down as unmineralised
osteoid (manufactured by osteoblasts). Mineralisation involves osteoblasts secreting vesicles
containing alkaline phosphatase. This cleaves the phosphate groups and acts as the foci for calcium
and phosphate deposition. The vesicles then rupture and act as a centre for crystals to grow on.
More particularly, bone mineral is formed from globular and plate structures, distributed among the
collagen fibrils of bone and forming yet larger structure. Hydroxyapatite crystals form slender
needles in the collagen fiber matrix. The resulting mineral containing fibrils form lamellar sheets.

Organic
The organic part of matrix is mainly composed of Type I collagen. This is synthesised
intracellularly as tropocollagen and then exported, forming fibrils. The organic part is also
composed of various growth factors, the functions of which are not fully known. Factors present
include glycosaminoglycans, osteocalcin, osteonectin, bone sialo protein, osteopontin and Cell
Attachment Factor. One of the main things that distinguish the matrix of a bone from that of
another cell is that the matrix in bone is hard.
2) Woven or lamellar bone (Microstructure of cortical bone)
Two types of bone can be identified microscopically according to the pattern of collagen
forming the osteoid (collagenous support tissue of type I collagen embedded in glycosaminoglycan
gel):
1) Woven bone characterised by haphazard organisation of collagen fibers and is mechanically
weak, and
2) Lamellar bone which has a regular parallel alignment of collagen into sheets (lamellae) and is
mechanically strong.
Woven bone is produced when osteoblasts produce osteoid rapidly which occurs initially in all
fetal bones (but is later replaced by more resilient lamellar bone). In adults woven bone is created after
fractures or in Paget's disease. Woven bone is weaker, with a smaller number of randomly oriented
collagen fibers, but forms quickly; it is for this appearance of the fibrous matrix that the bone is
termed woven. It is soon replaced by lamellar bone, which is highly organized in concentric sheets
with a much lower proportion of osteocytes to surrounding tissue. Lamellar bone, which makes its first
appearance in the fetus during the third trimester, is stronger and filled with many collagen fibers
parallel to other fibers in the same layer (these parallel columns are called osteons). In cross-section,
the fibers run in opposite directions in alternating layers, much like in plywood, assisting in the bone's
ability to resist torsion forces. After a fracture, woven bone forms initially and is gradually replaced by
lamellar bone during a process known as "bony substitution." Compared to woven bone , lamellar
bone formation takes place more slowly. The orderly deposition of collagen fibers restricts the
formation of osteoid to about 1 to 2µm per day. Lamellar bone also requires a relatively flat surface to
lay the collagen fibers in parallel or concentric layers.

Vascular supply and circulation

In a typical long bone, blood is supplied by three separate systems: a nutrient artery,
periosteal vessels, and epiphyseal vessels. The diaphysis and metaphysis are nourished primarily by
the nutrient artery. One or two nutrient artery enter the shaft of the long bones in oblique direction
through nutrient foramina, which passes through the cortex into the medullary cavity and then
ramifies outward through haversian and Volkmann canals to supply the cortex. Extensive vessels in
the periosteum, the membrane surrounding the bone, supply the superficial layers of the cortex and
connect with the nutrient-artery system. In the event of obstruction of the nutrient artery, periosteal
vessels are capable of meeting the needs of both systems. The epiphyses are supplied by a separate
system that consists of a ring of arteries entering the bone along a circular band between the growth
plate and the joint capsule. In the adult these vessels become connected to the other two systems at the
metaphyseal-epiphyseal junction, but while the growth plate is open there is no such connection, and
the epiphyseal vessels are the sole source of nutrition for the growing cartilage; therefore they are
essential for skeletal growth.
Drainage of blood is by a system of veins that runs parallel with the arterial supply and by
veins leaving the cortical periosteum through muscle insertions. Muscle contraction milks blood
outward, giving rise to a centrifugal pattern of flow from the axial nutrient artery through the cortex
and out through muscle attachments.
Bone Remodeling and Wolff’s Law
Wolff's law is a theory developed by the German Anatomist/Surgeon Julius Wolff (1836–1902)
in the 19th century that states that bone in a healthy person or animal will adapt to the loads it is
placed under. His theory proposed bone as a living tissue which is constantly undergoing modeling
and remodeling.
Wolff proposed that changes in the form and function of bones, or changes in function alone,
are followed by changes in the internal structure and shape of the bone in accordance with
mathematical laws. If loading on a particular bone increases, the bone will remodel itself over time to
become stronger to resist that sort of loading. The internal architecture of the trabeculae undergoes
adaptive changes, followed by secondary changes to the external cortical portion of the bone, perhaps
becoming thicker as a result. The converse is true as well: if the loading on a bone decreases, the bone
will become weaker due to turnover, it is less metabolically costly to maintain and there is no stimulus
for continued remodeling that is required to maintain bone mass.
The theory is supported by the observation that bones atrophy when they are not mechanically
stressed and hypertrophy when they are stressed. Although Wolff's proposal relates specifically to
bone, the law has also been applied to other connective tissues such as ligaments and tendons.
Bone Remodeling
Normal bone is always undergoing remodeling. Healthy bone remodeling occurs at many
simultaneous sites throughout the body where bone is experiencing growth, mechanical stress, micro-
fractures, or breaks. This remodeling removes old bone tissue and replaces it with new bone tissue.
About 20% of all bone tissue is replaced annually by the remodeling process. The remodeling cycle,
removing and building tissue, continues throughout life and is typically “in balance” to maintain
healthy bone.
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. This
remodeling cycle involves bone “resorption” by the osteoclasts. The osteoclasts remove the old
stressed or worn-out mineralized bone. This recreates a “resorption pit”. The “resorption” process
causes osteoblasts to become attracted to the resorption “pit”. Osteoblasts rebuild new bone tissue by
laying down an unmineralized matrix, called osteoid, which will eventually form new mineralized
bone. When this rebuilding is complete, the area of bone remodeling rests until the next remodeling
cycle begins.
Bone Remodeling Cycle
 Phase Phase Events
1. Pre-osteoclasts are attracted to the remodeling sites.
Activation
2. Pre-osteoclasts fuse to form multinucleated osteoclasts.
3. Osteoclasts dig out a cavity, called a resorption pit, in spongy bone or
burrow a tunnel in compact bone.
Resorption
4. Calcium can be released into the blood for use in various body functions.
5. Osteoclasts disappear.
6. Mesenchymal stem cells, pre-cursors to osteoblasts, appear along the burrow
or pit where they...
Reversal
7. proliferate (increase in numbers) and differentiate (change) into pre-
osteoblasts, then ...
8. mature into osteoblasts at the surface of the burrow or pit and ...
Formation 9. release osteoid at the site, forming a new soft nonmineralized matrix.
10. The new matrix is mineralized with calcium and phosphorous.
Quiescence 11. Site, with resting lining cells, remains dormant until the next cycle.

Conclusion:

The bone is a dynamic, living tissue; not the hard, dry, lifeless frame. Although it is hard, it has
a definite cellular structure and molecular structure. Bone is made up of living and non-living
components. There are living cells (collagen, and various cells like osteoblast, osteoclast, osteocytes
etc. etc.) and non-living; minerals (calcium, Phosphorus, carbonates, water etc). It has a blood supply
and nerve innervations.
Like most other tissues, broken bone can repair itself. The healing of the bone tissues starts im-
mediately after an injury. The initial is an acute inflammatory phase to stop the bleeding by formation
of clots. Then a highly vascularized fibrous tissue is deposited by the blood around the broken ends.
This material begins the formation of a kind of protective, lumpy sleeve, called a callus, around the
broken ends, mainly cartilage. The callus hardens into spongy bone, normally within a month or two.
Then, the spongy bone begins to be reduced in size by bone-dissolving cells produced in the marrow,
while at the same time the spongy bone in the area of the break is beginning to be replaced by hard
bone.
The bone over the life period is undergoing constant changes of modeling and remodeling. Re-
modeling occurs at many simultaneous sites throughout the body where bone is experiencing growth,
mechanical stress, micro-fractures, or breaks. This remodeling removes old bone tissue and replaces it
with new bone tissue. Also there is removal of old and damaged cells with new bone cells. The bone is
dynamic in terms if shape as well. The bone not only maintains its cellular structure but also adapts it-
self to its new surroundings. i.e. increase in load to bone adapts itself accordingly by remodeling. This
may be increase in thickness of bone, increase in bone density etc. that it adapts to bear the increase or
decrease in work load. Also there are consequent changes in the molecular and cellular structure to
make bone thicker. Thus bone is a living dynamic tissue.
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