Functional adaptation of the human locomotor system to normal and abnormal loading patterns

The adaptation of bone to its mechanical environment can be understood only in the context of its relationships to the soft tissues of the locomotor system, and its dual requirements to provide structural support and preserve articular cartilage. Radiographic analysis of the human skeleton provides insights into the nature of load transmission. Bone's adaptation to abnormal situations such as arthritis, or total joint implants, provides information about the limits of its tolerance to altered load or strain patterns. Knowledge gained from analysis of the first 20 years of total joint arthroplasty should provide prostheses of improved design and materials in the future.