Bone resorption and formation on the periosteal envelope of the ilium: A histomorphometric study in healthy women

Abstract Continuation of net periosteal bone gain after cessation of longitudinal growth has been inferred from sequential radiographic morphometry. Accordingly, we performed histomorphometry of the periosteal surfaces of transilial bone biopsies from 57 healthy women aged 24–74 years, 29 premenopausal and 28 postmenopausal. Compared to the endocortical surface, the extents of eroded and osteoid surfaces were very similar, but the extents of osteoclast- and osteoblast-covered surfaces were 80–90% smaller, and both wall thickness and osteoid thickness were about 30% lower. Double tetracycline labels were present in only 11 cases. The second (demethylchlortetracycline) label was almost four times as long as the first (oxytetracycline) label, a much greater difference than on the endocortical surface, so that the extent of mineralizing surface was based only on the second label. Even so, adjusted apposition rates and bone formation rates were only about 20% of the endocortical values, and unlike the endocortical surface, formation rates were not higher in the postmenopausal than in the premenopausal women. Resorption, reversal, and formation periods were each much longer than on the endocortical surface. There was no correlation between periosteal and endocortical values for any variable. At least 54% of total cement line length was scalloped, implying reversal of remodeling direction from resorption to formation, and at least 18% of total cement line length was smooth, implying temporary arrest of bone formation. Convincing evidence of modeling, related to growth or mechanical stimulation, was not observed. We conclude (1) periosteal bone turnover occurs by remodeling rather than modeling; it is much slower than endosteal turnover and extends less far from the surface, (2) periosteal bone formation is probably discontinuous with long periods of interruption, and (3) periosteal bone cell recruitment and activity appear to be relatively uninfluenced by the hormonal changes of aging and menopause; presumably local factors, possibly biomechanical, are more important.