Alper DUNKI
Bone and Joint Biology
Bone Functions: Support, mineral homeostasis, marrow housing
Bone Types: Long (endochondral), flat (intramembranous)
Macrostructure:
Cortical → dense, load-bearing
Trabecular → porous, marrow-rich, weak in osteoporosisCells:
Osteoblasts (matrix formation, Runx2, osterix)
Osteocytes (mechanosensors, RANKL secretion)
Osteoclasts (resorption, RANKL/M-CSF, inhibited by OPG)Matrix: Mineral (HA, TCP) + collagen (type I) + growth factors (BMP, TGF-β, IGF)
Bone Homeostasis: Balance of formation/resorption → disrupted in osteoporosis, osteopetrosis
Fracture Healing:
Primary → direct, stable fixation
Secondary → hematoma, callus, endochondral ossification, remodellingTherapies: Bisphosphonates, PTH (intermittent), anti-RANKL, calcitonin
Synovial Joint: Cavity, capsule, cartilage, synovium (Type A & B cells), synovial fluid (HA, lubricin); proprioception (A fibers), pain (C fibers).
Non-Synovial Joints:
Symphysis (fibrocartilage, e.g. pubic symphysis)
Synchondrosis (cartilage-only, e.g. costal, cranial base)
Syndesmosis (fibrous, e.g. distal tibiofibular)
Bone
Functions: Provides mechanical support, regulates mineral homeostasis, harbors bone marrow elements.
Types:
Long bones: Formed via endochondral ossification from a cartilage model.
Flat bones: Formed via intramembranous ossification directly from mesenchymal tissue.
Anatomy:
Diaphysis: Cortical bone tube enclosing the medullary canal with trabecular bone; surfaces consist of periosteum and endosteum.
Metaphysis: Transition zone between epiphysis and diaphysis; composed of loose trabecular bone.
Epiphysis: Articular end containing subchondral bone and the growth plate.
Vascular and neural supply: Neurovascular bundles enter through the periosteum and run within Haversian and Volkmann canals. Inner two-thirds of cortical bone are supplied by the nutrient artery, while the outer one-third is nourished by periosteal vessels.
Macrostructure:
Cortical bone: Dense, load-bearing; serves as boundary in metaphysis/epiphysis.
Trabecular bone: Porous, marrow-containing; architecture compromised in osteoporosis.
Microstructure:
Woven bone: Primary bone, irregular collagen alignment.
Lamellar bone: Secondary bone, organized structure.
Lacunar–canalicular system: Provides osteocyte interconnections.
Extracellular matrix:
Mineral (60–70%): Hydroxyapatite, tricalcium phosphate; provides compressive strength and mineral reservoir.
Organic (20–25%): 90% type I collagen, other collagens, adhesive proteins (fibronectin, vitronectin), matrix proteins, proteoglycans, growth factors (BMP, TGF-β, IGF).
Cells:
Osteoblasts: Synthesize bone matrix, regulate osteoclasts; differentiation via Runx2 and osterix.
Osteocytes: Mechanosensors, secrete RANKL, maintain bone homeostasis.
Osteoclasts: Multinucleated, perform bone resorption; activated by RANKL and M-CSF, inhibited by OPG.
Bone homeostasis: Maintained by the balance of osteoblast and osteoclast activity. Renewal occurs via Howship’s lacunae in trabecular bone and osteons in cortical bone.
Disease and treatment:
Remodeling impaired in conditions like osteoporosis and osteopetrosis.
Therapies: Bisphosphonates, intermittent PTH, anti-RANKL agents, calcitonin.
Fracture healing:
Primary healing: Direct bone formation under stable fixation.
Secondary healing: Hematoma, inflammation, cartilage callus, endochondral ossification, and remodeling.
Growth factors (BMP, TGF-β, IGF) and angiogenesis play critical roles.
2. Synovial Joint
Structure: Joint cavity, articular cartilage, capsule, ligaments, tendons.
Development: Arises from mesenchymal condensation; apoptosis within interzone forms the cavity.
Components:
Articular cartilage: Provides low-friction motion.
Ligaments: Provide stability.
Capsule: Encloses the joint.
Synovium: Contains type A cells (macrophage-like) and type B cells (fibroblast-like, producing hyaluronan); provides nutrition and synovial fluid.
Synovial fluid: Plasma ultrafiltrate rich in hyaluronic acid and lubricin.
Innervation:
Type A fibers (proprioception).
Type C fibers (pain).
Function: Enables wide range of motion between bones with minimal friction.
3. Non-Synovial Joints
Types:
Symphysis: Fibrocartilaginous disc between bones (e.g., intervertebral disc, pubic symphysis); stability, load transfer, limited mobility.
Synchondrosis: Cartilage-covered joint surfaces without synovium; limited motion (e.g., sternomanubrial, costal cartilage, cranial base).
Syndesmosis: Fibrous connection without cartilage interface; limited movement (e.g., distal tibiofibular joint).
1. Parini P, Canalis E, Schilling T. Bone remodeling: an operational process ensuring survival and function. Bone Res. 2022;10:8. doi:10.1038/s41413-022-00219-8
2. Sims NA, Gooi JH. Current perspectives on the multiple roles of osteoclasts. J Mol Endocrinol. 2024
