Abstract
Fatigue is a common cause of bone failure. As the main load-bearing tissue, cortical bone carries a considerable share of load in the whole bone. Under cyclic loading condition, microdamage may generates and accumulates in cortical bone, which further triggers the fracture of bone. It is crucial to explore the fatigue properties of cortical bone and the influential factors for both clinical diagnosis and establishment of models that can predict fatigue failure of human cortical bone. In this review, the fatigue behavior of cortical bone was investigated. Through the complex hierarchical structure and self-repairing process, the risk of catastrophic fracture is reduced. Based on these understandings, the multiple influential factors of cortical bone fatigue properties were analyzed, which were considered to be a combination of internal and external factors. The internal factors include material properties of bone composition (i.e., mineral, organic material, and water) and bone structure. External factors refer to loading condition such as frequency, amplitude and direction of load. Besides, age, disease, radiation exposure and other factors affect the fatigue behavior of bone by altering one or more factors mentioned above.
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