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. 2020 Jun 12;48(3):140–148. doi: 10.1249/JES.0000000000000225

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Schematic of the four mechanoadaptive responses at the cellular level. Formation modeling [A]: osteocyte perturbation by mechanical loading induces osteoblastic bone formation on a surface. Targeted remodeling [B]: microcracks generated during loading stimulate osteocyte apoptosis and targeted removal of bone by osteoclasts and subsequent formation of bone by osteoblasts. Disuse-mediated remodeling [C]: osteocyte apoptosis with disuse stimulates bone resorption and coupled formation. Also depicted is the negative bone balance within each remodeling unit that can accompany disuse-mediated remodeling. Resorption modeling [D]: disuse-mediated osteocyte apoptosis stimulates osteoclastic bone resorption on a surface. Note: Trabecular, trench-like bone remodeling is depicted for simplicity rather than centripetal bone formation around a vascular canal as occurs in remodeling of cortical bone.