The term “bone quality” is frequently used by clinicians, basic scientists, and engineers. However, do they mean the same thing? In this symposium, we asked the authors what they meant by “bone quality,” and as the reader will discover, there are many aspects of bone quality that vary in importance and scope with the person providing the definition. In recent years, numerous reviews have explored and described bone quality (eg, [2‐25, 29]) and some have discussed therapies for fragility fractures [13], but none has emphasized the transition from the bench to the bedside (and the operating room). In fact, the majority of these reviews of bone quality are either engineering or basic bone biology articles [3‐6, 10, 11, 16], including imaging techniques [3, 8, 12, 17, 20, 25], or papers on how to treat osteoporosis [5, 7, 9, 15, 18, 19, 21, 23, 24]. Here too we review those topics, providing recent research data from leaders in the field. This symposium reviews and makes suggestions for appropriate management of individuals with impaired bone quality because the orthopaedic surgeon sees cases where the quality of the bone is abnormal, whether in patients with osteoporosis, osteopetrosis, cancer [14], or a metabolic problem, such as diabetes [22], kidney disease [29], or rheumatoid arthritis, and because little guidance is available on pre- and postsurgical management of these cases.
