Subchondral bone remodelling in osteoarthritis
Subchondral bone remodelling in osteoarthritis
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DOI：
10.1302/2058-5241.4.180102
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发表时间：
2019-06-01
影响因子：
3.4
通讯作者：
Donell, Simon
中科院分区：
文献类型：
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作者：
Donell, Simon
软骨下骨重建是骨关节炎的一个组成部分，包括软骨下硬化的发展，沿着骨赘的形成。这些变化的发展是由于持续的异常机械应力，在软骨下骨和骨软骨连接处产生细胞和生物分子对微骨折的反应。MRI扫描的早期迹象是骨髓病变。在此阶段，通过纠正异常负载可以进行修复。持续存在会导致骨延迟愈合或骨不连。骨软骨连接处的微骨折，加上关节软骨开裂和丢失，骨关节炎是一种骨关节炎性疾病，它可使关节液沿着细胞因子和其他与骨细胞反应的分子渗透到软骨下骨，从而增加病理效应。旨在帮助骨科医生了解骨关节炎的发病机制和手术治疗的作用。
Subchondral bone remodelling is an integral part of osteoarthritis and involves the development of subchondral sclerosis seen on plain imaging, along with osteophyte formation.The development of these changes is due to persistent abnormal mechanical stresses which create a cellular and biomolecular response to microfractures in the subchondral bone and osteochondral junction.An early sign is bone marrow lesions seen on MRI scanning. Healing can occur at this stage by correcting the abnormal loads. Persistence leads to what is thought to be a delayed union or nonunion response by the bone.Microfractures of the osteochondral junction, coupled with articular cartilage fissuring and loss, allows synovial fluid to penetrate the subchondral bone along with cytokines and other molecules reacting with the bone cells to increase the pathological effects.This review gives an overview of the current thoughts on subchondral bone remodelling in osteoarthritis that is aimed at orthopaedic surgeons to help in the understanding of the pathogenesis of osteoarthritis and the role of surgical management.