Pathogenetic and clinical aspects of osteoarthritis and osteoarthritis-associated defects of the cartilage of the knee joint from the standpoint of understanding the role of the subchondral bone

Abstract

The article presents an analytical review on modern ideas about the osteoarthritis pathogenesis based on the findings regarding the subchondral bone and its importance in the development of this disease. It is shown that the data of numerous studies in recent years reveal more and more evidence demonstrating the primacy of pathological changes in the subchondral bone in the development of osteoarthritis and its progression. The vast majority of scientific papers confirm the fact that hyaline cartilage and subchondral bone tissue are a single morphofunctional biocomposite with an interdependent system of biochemical connections and molecular signaling, as well as correlative reactions to stressful mechanical loads. The authors analyzed in detail the mechanisms of cellular and molecular interaction in the system "hyaline cartilage — subchondral bone" in the development of osteoarthritis, vividly demonstrating the active and priority involvement of subchondral bone tissue in the debut and maintenance of the destructive-dystrophic process. The necessity to leave the chondrocentric model of osteoarthritis pathogenesis and the expediency to revise the points of application of therapeutic measures in patients with knee joint osteoarthritis are discussed. The current methods of surgical treatment of knee joint osteoarthritis are critically reviewed from the perspective of their pathogenetic orientation. The authors discuss the relevance in developing the concept of organ-preserving surgery in destructive-dystrophic joint lesions, which should be based on the findings describing the role and significance of subchondral and metaphyseal bone tissue in the above pathologic processes.

Keywords

osteoarthritis / subchondral bone / articular cartilage / articular cartilage defect / knee joint

References

[1] Alekseeva LI, Taskina EA, Kashevarova NG. Osteoarthritis: epidemiology, classification, risk factors, and progression, clinical presentation, diagnosis, and treatment. Modern Rheumatology Journal. 2019;13(2):9–21. (In Russ). doi: 10.14412/1996-7012-2019-2-9-21

[2] Алексеева Л.И., Таскина Е.А., Кашеварова Н.Г. Остео-артрит: эпидемиология, классификация, факторы риска и прогрессирования, клиника, диагностика, лечение // Современная ревматология. 2019. Т. 13, № 2. С. 9–21. doi: 10.14412/1996-7012-2019-2-9-21

[3] Kabalyk MA. Biomarkers of subchondral bone remodeling in osteoarthritis. Pacific Medical Journal. 2017;(1):37–41. (In Russ). doi: 10.17238/PmJ1609-1175.2017.1.37-41

[4] Кабалык М.А. Биомаркеры и участники ремоделирования субхондральной кости при остеоартрозе // Тихоокеанский медицинский журнал. 2017. № 1. С. 37–34. doi: 10.17238/PmJ1609-1175.2017.1.37-41

[5] Alan B. The Bone Cartilage Interface and Osteoarthritis. Calcified Tissue International. 2021;109(3):303–328. doi: 10.1007/s00223-021-00866-9

[6] Alan B. The Bone Cartilage Interface and Osteoarthritis // Calcified Tissue International. 2021. Vol. 109, № 3. P. 303–328. doi: 10.1007/s00223-021-00866-9

[7] Ashish RS, Supriya J, Sang-Soo L, Ju-Suk N. Interplay between Cartilage and Subchondral Bone Contributing to Pathogenesis of Osteoarthritis. Int J Mol Sci. 2013;14(10):19805–19830. doi: 10.3390/ijms141019805

[8] Ashish R.S., Supriya J., Sang-Soo L., Ju-Suk N. Interplay between Cartilage and Subchondral Bone Contributing to Pathogenesis of Osteoarthritis // Int J Mol Sci. 2013. Vol. 14, № 10. P. 19805–19830. doi: 10.3390/ijms141019805

[9] Loef M, van Beest S, Kroon FPB, et al. Comparison of histological and morphometrical changes underlying subchondral bone abnormalities in inflammatory and degenerative musculoskeletal disorders: a systematic review. Osteoarthritis Cartilage. 2018;26(8):992–1002. doi: 10.1016/j.joca.2018.05.007

[10] Loef M., van Beest S., Kroon F.P.B., et al. Comparison of histological and morphometrical changes underlying subchondral bone abnormalities in inflammatory and degenerative musculoskeletal disorders: a systematic review // Osteoarthritis Cartilage. 2018. Vol. 26, № 8. P. 992–1002. doi: 10.1016/j.joca.2018.05.007

[11] Goldring SR, Goldring MB. Changes in the osteochondral unit during osteoarthritis: structure, function, and cartilage-bone crosstalk. Nat Rev Rheumatol. 2016;12(11):632–44. doi: 10.1038/nrrheum.2016.148

[12] Goldring S.R., Goldring M.B. Changes in the osteochondral unit during osteoarthritis: structure, function, and cartilage-bone crosstalk // Nat Rev Rheumatol. 2016. Vol. 12, № 11. P. 632–644. doi: 10.1038/nrrheum.2016.148

[13] Boyde A, Davis GR, Mills D, et al. On fragmenting, densely mineralized acellular protrusions into articular cartilage and their possible role in osteoarthritis. J Anat. 2014;225(4):436–446. doi: 10.1111/joa.12226

[14] Boyde A., Davis G.R., Mills D., et al. On fragmenting, densely mineralized acellular protrusions into articular cartilage and their possible role in osteoarthritis // J Anat. 2014. Vol. 225, № 4. P. 436–446. doi: 10.1111/joa.12226

[15] Alexeeva LI, Zaitseva EM. Role of subchondral bone in osteoarthritis. Rheumatology Science and Practice. 2009;47(4):41–48. (In Russ). doi: 10.14412/1995-4484-2009-1149

[16] Алексеева Л.И., Зайцева Е.М. Роль субхондральной кости при остеоартрозе // Научно-практическая ревматология. 2009. Т. 47, № 4. С. 41–48. doi: 10.14412/1995-4484-2009-1149

[17] Roy KA, Jennifer R, Jonathan PD. Contribution of Circulatory Disturbances in Subchondral Bone to the Pathophysiology of Osteoarthritis. Curr Rheumatol Rep. 2017;19(8):49. doi: 10.1007/s11926-017-0660-x

[18] Roy K.А., Jennifer R., Jonathan P.D. Contribution of Circulatory Disturbances in Subchondral Bone to the Pathophysiology of Osteoarthritis // Curr Rheumatol Rep. 2017. Vol. 19, № 8. Р. 49. doi: 10.1007/s11926-017-0660-x

[19] Kuttapitiya A, Assi L, Laing K, et al. Microarray analysis of bone marrow lesions in osteoarthritis demonstrates upregulation of genes implicated in osteochondral turnover, neurogenesis and inflammation. Ann Rheum Dis. 2017;76(10):1764–1773. doi: 10.1136/annrheumdis-2017-211396

[20] Kuttapitiya A., Assi L., Laing K., et al. Microarray analysis of bone marrow lesions in osteoarthritis demonstrates upregulation of genes implicated in osteochondral turnover, neurogenesis and inflammation // Ann Rheum Dis. 2017. Vol. 76, № 10. P. 1764–1773. doi: 10.1136/annrheumdis-2017-211396

[21] Butterfield NC, Curry KF, Steinberg J, et al. Accelerating functional gene discovery in osteoarthritis. Nat Commun. 2021;12(1):467. doi: 10.1038/s41467-020-20761-5

[22] Butterfield N.C., Curry K.F., Steinberg J., et al. Accelerating functional gene discovery in osteoarthritis // Nat Commun. 2021. Vol. 12, № 1. P. 467. doi: 10.1038/s41467-020-20761-5

[23] Zhen G, Wen C, Jia X, et al. Inhibition of TGF-beta signaling in mesenchymal stem cells of subchondral bone attenuates osteoarthritis. Nat Med. 2013;19(6):704–12. doi: 10.1038/nm.3143

[24] Zhen G., Wen C., Jia X., et al. Inhibition of TGF-beta signaling in mesenchymal stem cells of subchondral bone attenuates osteoarthritis // Nat Med. 2013. Vol. 19, № 6. P. 704–712. doi: 10.1038/nm.3143

[25] Li G, Zheng Q, Landao-Bassonga E, Cheng TS, et al. Influence of age and gender on microarchitecture and bone remodeling in subchondral bone of the osteoarthritic femoral head. Bone. 2015;(77):91–7. doi: 10.1016/j.bone.2015.04.019

[26] Li G., Zheng Q., Landao-Bassonga E., Cheng T.S., et al. Influence of age and gender on microarchitecture and bone remodeling in subchondral bone of the osteoarthritic femoral head // Bone. 2015. № 77. P. 91–97. doi: 10.1016/j.bone.2015.04.019

[27] Egiazaryan KA, Lazishvili GD, Hramenkova IV, et al. Knee osteochondritis dissecans: surgery algorithm. Vestnik RGMU. 2018;(2):77–83. (In Russ). doi: 10.24075/brsmu.2018.020

[28] Егиазарян К.А., Лазишвили Г.Д., Храменкова И.В., и др. Алгоритм хирургического лечения больных с рассекающим остеохондритом коленного сустава // Вестник РГМУ. 2018. № 2. C. 77–83. doi: 10.24075/brsmu.2018.020

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