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To introduce this topic, the skeletal vascular anatomy and techniques for measuring bone blood flow are briefly discussed.Ī dense vascular network delivers oxygen and nutrients to all 206 bones in the human body. Although a variety of skeletal disorders are associated with general vascular dysfunction ( 5– 7), this review will focus on the regulation of bone blood flow, through the number and size of vessels, during bone repair and regeneration. These two factors are regulated through the processes of angiogenesis and vasomotor function, respectively. Given that blood pressure is generally maintained, the number and size of blood vessels determines the local blood flow rate. The rate at which blood vessels deliver oxygen, nutrients, growth factors, and circulating cells to boneis tightly regulated as a function of blood pressure and vascularization. Readers are referred to recent publications for more information about the active processes of the vasculature not covered in this review, including the vascular niche and hypoxia-driven signaling pathways ( 3, 4). As a consequence of this environment, the blood vessels in bone are highly active, not simply a passive source for the delivery of nutrients ( 2).
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In addition, blood vessels lost due to trauma are regenerated, and new bone tissue formed in response to injury is vascularized.
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Many studies have demonstrated that the blood vessels in bone are necessary for nearly all skeletal functions, including development, homeostasis, and repair ( 1). However, a frequently overlooked feature of bone is its extensive vascular network. All biological tissues, including bone, require vascular support to survive.