Abstract
Repetitive mechanical loading of bone can lead to ultrastructural-level damage, which can lead to fracture if not repaired. Skeletal fractures result not only from a loss in bone mass, but also because of alterations in tissue quality. Therefore, it is important to also delineate how changes in tissue ultrastructure affect the mechanistic response of bone to its physical environment. In this overview, factors affecting tissue quality, in particular fatigue resistance, are reviewed, followed by examples of recent work that has identified ultrastructural and compositional changes that occur in bone during fatigue.
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