Orthopaedic Biomechanics Lab, Sunnybrook Research Institute, University of Toronto, Toronto, Canada.
Department of Surgery, University of Toronto, Toronto, Canada.
Curr Osteoporos Rep. 2020 Dec;18(6):705-715. doi: 10.1007/s11914-020-00633-z. Epub 2020 Oct 19.
Skeletal metastasis involves the uncoupling of physiologic bone remodeling resulting in abnormal bone turnover and radical changes in bony architecture, density, and quality. Bone strength assessment and fracture risk prediction are critical in clinical treatment decision-making. This review focuses on bone tissue and structural mechanisms altered by osteolytic metastasis and the resulting changes to its material and mechanical behavior.
Both organic and mineral phases of bone tissue are altered by osteolytic metastatic disease, with diminished bone quality evident at multiple length-scales. The mechanical performance of bone with osteolytic lesions is influenced by a combination of tissue-level and structural changes. This review considers the effects of osteolytic metastasis on bone biomechanics demonstrating its negative impact at tissue and structural levels. Future studies need to assess the cumulative impact of cancer treatments on metastatically involved bone quality, and its utility in directing multimodal treatment planning.
骨骼转移涉及生理骨重塑的解偶联，导致异常的骨转换和骨结构、密度和质量的根本变化。骨强度评估和骨折风险预测在临床治疗决策中至关重要。本综述重点关注溶骨性转移改变的骨组织和结构机制，以及其对材料和机械性能的影响。
溶骨性转移性疾病改变了骨组织的有机和矿物质相，在多个长度尺度上明显降低了骨质量。溶骨性病变的骨机械性能受组织水平和结构变化的共同影响。本综述考虑了溶骨性转移对骨生物力学的影响，证明了它在组织和结构水平上的负面影响。未来的研究需要评估癌症治疗对转移性受累骨质量的累积影响及其在指导多模式治疗计划中的效用。
