Introduction: Bone circulation plays an important role in bone
physiology, but has been relatively poorly studied, because most techniques of
circulatory research are difficult to apply to bone. This article summarizes
briefly some of the important aspects of the physiology of bone blood flow
most relevant to orthopaedics.
Methods: The gold standard for experimental measurement of bone
blood flow is the radioactive microsphere technique, though advances are being
made in other techniques, such as positron emission tomography, laser and
ultra-sound Doppler velocimetry, and near infrared spectroscopy, that may
provide useful clinical measurement in the future.
Results: Multiple vascular pathways contribute to an adaptive
response to traumatic disruption of bone circulation. The microcirculation is
not merely a passive conduit for blood flow, but plays an active role in
controlling bone processes such as osteochondral ossification.
Discussion: The pathophysiology of bone circulation has been
associated with osteonecrosis, but more and more evidence is pointing to the
importance of bone circulation in fracture repair and osteoporosis, both of
which are potentially very exciting areas for future studies.