By Nigel Arden
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Extra info for Osteoporosis (Illustrated)
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Measurement of both components is essential, since the impact of a change in one is dependent on the direction and magnitude of change in the other. For example, a reduction in erosion depth will not alter remodeling balance if there is a quantitatively similar reduction in wall width, but it will lead to an improvement if the reduction in wall width is smaller than that in erosion depth. For drugs that predominantly act by reducing bone turnover, changes in remodeling balance are likely to have only modest effects on bone mass in view of the relatively low number of remodeling units present on the bone surface at any given time.
Changes in bone mineralization After the bone remodeling cycle has been completed, mineralization of the new bone continues (secondary mineralization). The degree of secondary mineralization is inversely related to bone turnover; the lower the bone turnover, the smaller the chance that mineralization will be halted by the process of activation of a new bone remodeling unit at that site. Thus, administration of potent antiresorptive agents (eg, the bisphosphonate alendronate) is associated with increased secondary mineralization, resulting in an increase in the degree of mineralization of bone [39].
54. Kaukonen JP, Karaharju EO, Porras M, et al. Functional recovery after fractures of the distal forearm: analysis of radiographic and other factors affecting the outcome. Ann Chir Gynaecol 1988;77:27–31. 55. O’Neill TW, Cooper C, Finn JD, et al. Incidence of distal forearm fracture in British men and women. Osteoporos Int 2001;12:555–8. 56. Melton LJ III, Cooper C. Magnitude and impact of osteoporosis and fractures. In: Marcus R, Feldman D, Kelsey J, eds: Osteoporosis. 2nd Edition (Vol 1). San Diego: Academic Press, 2001:557–67.