Functional adaptation of bone: The mechanostat and beyond

Abstract

The conceptual model of the mechanostat proposed by Harold Frost in 1983 is among the most significant contributions to musculoskeletal research today. This model states that bone and other musculoskeletal tissues including cartilage, tendon and muscle respond to habitual exercise/loading and that changes in the loading environment lead to adequate structural adaptation of (bone) tissue architecture. The analogy with a thermostat clearly indicates presence of a physiological feedback system which is able to adjust bone mass and structure according to the engendered loads. In the bioengineering community, the mechanostat has been mathematically formulated as a feedback algorithm using a set p..