Bone remodelling in osteoarthritis

David Burr, Maxime A. Gallant

Research output: Contribution to journalArticle

262 Citations (Scopus)

Abstract

The classical view of the pathogenesis of osteoarthritis (OA) is that subchondral sclerosis is associated with, and perhaps causes, age-related joint degeneration. Recent observations have demonstrated that OA is associated with early loss of bone owing to increased bone remodelling, followed by slow turnover leading to densification of the subchondral plate and complete loss of cartilage. Subchondral densification is a late event in OA that involves only the subchondral plate and calcified cartilage; the subchondral cancellous bone beneath the subchondral plate may remain osteopenic. In experimental models, inducing subchondral sclerosis without allowing the prior stage of increased bone remodelling to occur does not lead to progressive OA. Therefore, both early-stage increased remodelling and bone loss, and the late-stage slow remodelling and subchondral densification are important components of the pathogenetic process that leads to OA. The apparent paradoxical observations that OA is associated with both increased remodelling and osteopenia, as well as decreased remodelling and sclerosis, are consistent with the spatial and temporal separation of these processes during joint degeneration. This Review provides an overview of current knowledge on OA and discusses the role of subchondral bone in the initiation and progression of OA. A hypothetical model of OA pathogenesis is proposed.

Original languageEnglish
Pages (from-to)665-673
Number of pages9
JournalNature Reviews Rheumatology
Volume8
Issue number11
DOIs
StatePublished - Nov 2012

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Bone Remodeling
Osteoarthritis
Sclerosis
Cartilage
Joints
Bone and Bones
Metabolic Bone Diseases
Theoretical Models

ASJC Scopus subject areas

  • Rheumatology

Cite this

Bone remodelling in osteoarthritis. / Burr, David; Gallant, Maxime A.

In: Nature Reviews Rheumatology, Vol. 8, No. 11, 11.2012, p. 665-673.

Research output: Contribution to journalArticle

Burr, David ; Gallant, Maxime A. / Bone remodelling in osteoarthritis. In: Nature Reviews Rheumatology. 2012 ; Vol. 8, No. 11. pp. 665-673.
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