The bone remodelling cycle

Remodelling is designed to renew old bone and to replace bone with microfractures. The process leads to loss of bone mass and to disruption of the trabecular network with increasing age. In the shorter term, remodelling allows bone to be reshaped to adapt to mechanical stresses on the skeleton.

During the remodelling process, the osteoclasts and osteoblasts work closely together in time and space (coupling) in units known as bone multi-cellular units. Activation of resting osteoblasts on the surface of bone and stromal cells in the bone marrow is followed by a cascade of signals to stimulate recruitment and differentiation of osteoclasts from haematopoietic stem cells.

Activated osteoclasts resorb a discrete area of mineralised bone matrix, with the release of matrix components into the microenvironment. Capillary endothelial cells provide the microvasculature. Osteoblasts migrate into the resorption site and deposit new bone matrix (osteoid). They become embedded in osteoid and mature into osteocytes.

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