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Bone remodeling in osteoarthritis: subchondral and osteophytic responses

1999; Elsevier BV; Volume: 7; Issue: 3 Linguagem: Inglês

10.1053/joca.1998.0181

1522-9653

Roland W. Moskowitz,

Bone and Joint Diseases

OSTEOARTHRITIS can be considered a collective endstage for heterogeneous etiopathologic conditions a#ecting joint tissues. Such etiopathologic factors are multifactorial and include biochemical, enzymatic, genetic and biomechanical factors amongst others. Characteristic pathologic findings include joint space narrowing, peripheral osteophytes, subchondral bony sclerosis and cyst formation. Although commonly considered a disease primarily involving cartilage, studies support variable roles for synovium, muscle, ligaments and bone. Radin and co-workers [1, 2] suggested an important role for subchondral bone changes as an etiologic factor in the early development of degenerative joint disease. Repetitive impulsive loading resulted in early responses characterized by increased bone formation, associated with relative sti#ening of bone; articular cartilage degeneration followed [3]. Subchondral bone changes preceding cartilage damage in osteoarthritis have been demonstrated in other animal models. Examination of trabecular bone within the femoral head of Hartley strain guinea pigs, a strain predisposed to osteoarthritis, demonstrated subchondral trabecular remodeling as an early event in this model of OA [4]. Serial observations in this model utilizing magnetic resonance imaging revealed significant progression of subchondral sclerosis as well as osteophytes during disease development [5]. A longitudinal study of subchondral bone responses in dogs undergoing anterior cruciate ligament transection revealed subchondral sclerosis at 18 months and 54 months, but not at 3 months; findings were associated with loss of subchondral trabecular bone at all three time points. Findings suggested that bony changes were associated with progression of cartilage degeneration, rather than initial development [6]. Experimentally induced osteoarthritis following partial meniscectomy (PM) in the rabbit was associated with prominent osteophyte formation [7]. Increased cellular replication was noted early (at