From osteology to osteo-myology: three decades of continuous, original contributions to musculoskeletal biomechanical analysis

Abstract

In consonance with the traditional spirit of our studies, skeletal research is being progressively focused on the structural- biomechanical analysis of bone and the muscle-bone interactions. In this article, the CEMFoC’s members summarize their original findings in bone biomechanics and their potential clinical applications. These findings provided evidence supporting two fundamental hypotheses, namely, A. bones constitute resistive structures, which are biologically servo-controlled (‘Bones tend to maintain a safety factor which allows the body to function normally avoiding fractures’ – the ‘Utah paradigm’), and B. the interactions of bones with their mechanical environment mainly are determined by the contraction of local muscles - ‘bone-muscle
units’), and are subordinated to the control of the metabolic environment (‘Bones are what muscles wish them to be, provided that
hormones allow for it’). The achievements in the field are presented in a chronological and didactical sequence concerning the general knowledge in Osteology and the development of novel resources for non-invasive diagnosis of bone fragility, aiming to distinguish between osteopenias and osteoporosis and the ‘mechanical’ and ‘metabolic’ etiology of these conditions. Finally, the integrated new knowledge is presented as supporting for a proposed diagnostic algorithm for osteopenias and osteoporosis. In general terms, the article highlights the dynamic evaluation of the musculoskeletal system as a whole, opening a new diagnostic field for a personalized evaluation of the patients affected by a boneweakening disease, based on functional and biomechanical criteria.