{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T20:03:37Z","timestamp":1776974617722,"version":"3.51.4"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T00:00:00Z","timestamp":1618876800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T00:00:00Z","timestamp":1618876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"The Michael Uren Foundation"},{"DOI":"10.13039\/501100003754","name":"Dr. Mortimer and Theresa Sackler Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003754","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Curr Osteoporos Rep"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose of Review<\/jats:title>\n                <jats:p>Bone matrix exhibits great complexity in its composition, structure and mechanics. Here, we provide a review of recent research articles and appraise the evidence that bone matrix quality is clinically important and possibly targetable for fracture prevention.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Recent Findings<\/jats:title>\n                <jats:p>Deformation of mineralised collagen fibrils determines bone fracture mechanics. Slipping and separation at the mineral-fibril and fibril-fibril interfaces, respectively, are the structural mechanisms for plastic deformation and microcrack nucleation. Existing technologies for assessing bone tissue in vivo cannot measure matrix structure or fracture mechanics but have shown limited use in clinical settings for identifying fragility or following treatment outcomes based on composition.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Summary<\/jats:title>\n                <jats:p>Matrix is biomechanically and clinically important, but the knowledge has not translated into clinical practice. The structural mechanisms by which a load is transferred from mineralised collagen fibrils to the whole bone via microcracking have been proven too complex to measure in vivo. The mineral-fibril or fibril-fibril interfaces might be suitable targets for diagnosing fragility or delivering molecules that reduce fracture risk by strengthening the mineral bonds while maintaining flexibility in the fibrils.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11914-021-00678-8","type":"journal-article","created":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T01:02:59Z","timestamp":1618880579000},"page":"318-326","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Clinical Importance of Bone Matrix Damage Mechanisms for Fracture Prevention"],"prefix":"10.1007","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5197-3086","authenticated-orcid":false,"given":"Richard L.","family":"Abel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Stavri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marena","family":"Gray","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Hansen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,4,20]]},"reference":[{"issue":"2","key":"678_CR1","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1007\/s001980200000","volume":"13","author":"CH Turner","year":"2002","unstructured":"Turner CH. Biomechanics of bone: determinants of skeletal fragility and bone quality. Osteoporos Int. 2002;13(2):97\u2013104.","journal-title":"Osteoporos Int"},{"issue":"21","key":"678_CR2","doi-asserted-by":"publisher","first-page":"2250","DOI":"10.1056\/NEJMra053077","volume":"354","author":"E Seeman","year":"2006","unstructured":"Seeman E, Delmas PD. Bone quality--the material and structural basis of bone strength and fragility. N Engl J Med. 2006;354(21):2250\u201361.","journal-title":"N Engl J Med"},{"key":"678_CR3","doi-asserted-by":"crossref","unstructured":"Vahle JL, Ma YL, Burr DB. Skeletal assessments in the nonhuman primate. In: Bluemel J, Korte S, Schenck E, Weinbauer GFBT-TNP in NDD and SA, editors. 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Reported stress cause mineralised collagen fibrils to slip (i.e., pre separate) resulting in cracks at the interfaces.","journal-title":"J Mech Behav Biomed Mater"},{"key":"678_CR6","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1016\/j.actbio.2019.02.053","volume":"89","author":"A Groetsch","year":"2019","unstructured":"Groetsch A, Gourrier A, Schwiedrzik J, Sztucki M, Beck RJ, Shephard JD, et al. Compressive behaviour of uniaxially aligned individual mineralised collagen fibres at the micro- and nanoscale. Acta Biomater. 2019;89:313\u201329.","journal-title":"Acta Biomater"},{"key":"678_CR7","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1016\/j.actbio.2017.07.030","volume":"60","author":"J Schwiedrzik","year":"2017","unstructured":"Schwiedrzik J, Taylor A, Casari D, Wolfram U, Zysset P, Michler J. Nanoscale deformation mechanisms and yield properties of hydrated bone extracellular matrix. 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Peak material strength coincides with mineral-fibril separation (i.e., peak mineral strain).","journal-title":"Sci Rep"},{"key":"678_CR10","doi-asserted-by":"publisher","first-page":"21072","DOI":"10.1038\/srep21072","volume":"6","author":"EA Zimmermann","year":"2016","unstructured":"Zimmermann EA, Schaible E, Gludovatz B, Schmidt FN, Riedel C, Krause M, et al. Intrinsic mechanical behavior of femoral cortical bone in young, osteoporotic and bisphosphonate-treated individuals in low- and high energy fracture conditions. Sci Rep. 2016;6:21072.","journal-title":"Sci Rep"},{"key":"678_CR11","doi-asserted-by":"publisher","first-page":"43399","DOI":"10.1038\/srep43399","volume":"7","author":"S Ma","year":"2017","unstructured":"\u2022\u2022 Ma S, Goh EL, Jin A, Bhattacharya R, Boughton OR, Patel B, et al. Long-term effects of bisphosphonate therapy: perforations, microcracks and mechanical properties. Sci Rep. 2017;7:43399. Applied synchrotron micro-CT to study micro-defects in trabecular bone cores. Hip-fractures were associated with fewer micro cracks but more osteoclastic trenches i.e., in interactivity between microcracks and remodelling exacerbates the weakening of bone caused by damage.","journal-title":"Sci Rep"},{"issue":"6","key":"678_CR12","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1016\/j.bone.2012.02.636","volume":"50","author":"CR Slyfield","year":"2012","unstructured":"Slyfield CR, Tkachenko EV, Fischer SE, Ehlert KM, Yi IH, Jekir MG, et al. Mechanical failure begins preferentially near resorption cavities in human vertebral cancellous bone under compression. Bone. 2012;50(6):1281\u20137.","journal-title":"Bone."},{"issue":"6","key":"678_CR13","doi-asserted-by":"publisher","first-page":"2127","DOI":"10.1007\/s10237-020-01328-1","volume":"19","author":"E Alizadeh","year":"2020","unstructured":"Alizadeh E, Dehestani M, Zysset P. 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