This 2006 NEJM review by Seeman and Delmas examines what determines bone strength beyond density. It defines how material composition (mineral content, collagen cross-linking) and structural design (cortical geometry, trabecular architecture) interact to resist fracture. It then explains how age-related failure of bone modeling and remodeling leads to fragility — and why this matters for how we use antiresorptive and anabolic drugs.
This 2006 NEJM review by Seeman and Delmas examines what determines bone strength beyond density. It defines how material composition (mineral content, collagen cross-linking) and structural design (cortical geometry, trabecular architecture) interact to resist fracture. It then explains how age-related failure of bone modeling and remodeling leads to fragility — and why this matters for how we use antiresorptive and anabolic drugs.