The accurate representation of trabecular bone morphology is essential for improving patient‑specific numerical analyses aimed at predicting local mechanical behaviour. However, the resolution of clinical CT scans is insufficient to capture trabecular patterns directly, and scan resolution is constrained by radiation‑dose limitations. As a result, there is a gap between the clinically available information and the level of microstructural detail required for advanced computational studies. Different strategies have attempted to infer bone microarchitecture from low‑resolution images, but either they rely on purely structural approaches driven by globally defined objectives (Topology Optimization) [1], are patient-agnostic [2], or are computationally prohibitive since they require solving entire high-resolution models [2]. To overcome these limitations, we introduce a two‑level strategy: First, a coarse-scale patient-specific model is used to analyse the whole bone, after which the domain is partitioned into independent cells with equilibrated boundary conditions. Subsequently, a sequential Topology Optimization and mechanotransduction process is executed independently for each cell generating consistent trabecular structures across cells and ensuring smooth microarchitectural continuity. ACKNOWLEDGEMENTS The authors gratefully acknowledge the financial support of: Project PID2022-141512NB-I00 financed by MCIN/AEI/10.13039/501100011033 and ERDF/UE. Grant FEDEGENT/2018/025 funded by Generalitat Valenciana. REFERENCES [1] J. Kim, et al., Topology Optimization-based Bone Microstructure Reconstruction from CT Scan Data. The 2021 World Congress on Advances in Structural Engineering and Mechanics (ASEM21) GECE, Seoul, Korea, August 23-26 (2021) [2] K. Tsubota, et al., Computer simulation of trabecular remodeling in human proximal femur using large-scale voxel FE models: Approach to understanding Wolff's law. Journal of Biomechanics, (2009) 29:42(8), 1088–1094. [3] T. Adachi et al., Simulation of Trabecular Surface Remodeling based on Local Stress Nonuniformity, JSME International Journal Series C, (1997) 40:4, 782-792