Table of ContentsView AllTable of ContentsDefinitionEffect of OARelated Conditions
Table of ContentsView All
View All
Table of Contents
Definition
Effect of OA
Related Conditions
Osteoarthritis (OA) is commonly referred to as wear-and-tear arthritis. However, researchers now understand that it is not entirely about worn cartilage. There are other elements of joint anatomy, such as subchondral bone tissue, that play a significant role in OA.
Additionally, there are other subchondral bone conditions, includingsubchondral sclerosisand the formation ofsubchondral cysts, that are associated with OA.
This article explains what the subchondral bone is and how subchondral bone damage contributes to OA. It will help you to better understand what happens to the subchondral bone in osteoarthritis.
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What Is Subchondral Bone?
Subchondral bone is the layer of bone just below thecartilagein a joint. “Chondral” refers to cartilage, while the prefix sub means below.
Subchondral bone serves as a shock absorber in weight-bearing joints like the knees. The bone has many blood vessels to supply it with nutrients and oxygen, and to take away wastes.
Cartilage doesn’t have its own blood supply, so the close association with the highly vascular subchondral bone is what keeps the cartilage nourished. These vessels provide over half of the hydration, oxygenation, and glucose for the cartilage.
Therefore, the health and function of the subchondral bone make a difference in the health of the cartilage that lies just above it.
What Is Bone Marrow Edema in the Knee?
How Osteoarthritis Affects Subchondral Bone
In osteoarthritis, the subchondral bone becomes thicker than usual. Research evidence suggests this thickening happens before the articular cartilage at the joint starts to wear away—an indication that subchondral bone plays a role in the development of osteoarthritis.
Subchondral bone attrition is the flattening or depression of the bone surface that forms part of a joint. This occurs in earlyknee osteoarthritisand indicates the potential for cartilage loss and misalignment of a knee compartment.
The subchondral bone is key to cartilage and joint health. Studies suggest that beyond joint wear and tear, cellular changes in the bone may lead to cartilage damage and osteoarthritis, with some evidence for the specific genetic changes involved.Researchers continue work to define how the subchondral bone contributes to OA.
Subchondral Conditions Associated With OA
Several other subchondral conditions are associated with osteoarthritis. These conditions are typically seen as part of a pattern with OA that leads to a diagnosis.
Subchondral Bone Marrow Edema
Subchondralbone marrow edema, a buildup of fluid also known as bone marrow lesions, is often seen together with subchondral bone attrition.
One theory is that wear and tear on the knee causes microfractures that require a constant state of repair. This cellular activity produces enzymes and proteins that may have further effects on the adjacent cartilage.
Researchers have also discovered that subchondral bone tissue produces several similarcytokinesand growth factors (proteins) that can cause inflammation and changes in cartilage tissue.More study is needed to identify which chemicals might be responsible and how they interact.
Subchondral Cyst
Asubchondral cystis often seen in osteoarthritis. This is a fluid-filled sac that extends from the joint, sometimes called a bone cyst.
However, cartilage and subchondral bone damage are key factors leading to the development of subchondral cysts.
Subchondral Sclerosis
Subchondral sclerosisoccurs because of increased bone density or thickening in the subchondral layer. When seen on X-ray or other imaging, the changes to cartilage in a knee or other affected joint are considered a hallmark finding for osteoarthritis.
One study suggests that the tiny microfractures of early OA, to which the body responds with frequent and repetitive repair activity to preserve cartilage, may lead to subchondral sclerosis. This, in turn, can lead to deformity and subchondral bone irregularity.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Findlay DM, Kuliwaba JS.Bone-cartilage crosstalk: a conversation for understanding osteoarthritis. Bone Res. 2016;4:16028. doi:10.1038/boneres.2016.28Li G, Yin J, Gao J, et al.Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes. Arthritis Res Ther. 2013;15(6):223. doi:10.1186/ar4405Huebner JL, Bay-Jensen AC, Huffman KM, et al.Alpha C-telopeptide of type I collagen is associated with subchondral bone turnover and predicts progression of joint space narrowing and osteophytes in osteoarthritis. Arthritis Rheumatol. 2014;66(9):2440-9. doi:10.1002/art.38739Huan C, Gao J.Insight into the potential pathogenesis of human osteoarthritis via single-cell RNA sequencing data on osteoblasts.Math Biosci Eng. 2022 Apr 20;19(6):6344-6361. doi:10.3934/mbe.2022297Roemer FW, Neogi T, Nevitt MC, et al.Subchondral bone marrow lesions are highly associated with, and predict subchondral bone attrition longitudinally: the MOST study. Osteoarthr Cartil. 2010;18(1):47-53. doi:10.1016/j.joca.2009.08.018Donell S.Subchondral bone remodelling in osteoarthritis. EFORT Open Rev. 2019;4(6):221-229. doi:10.1302/2058-5241.4.180102Kaspiris A, Chronopoulos E, Vasiliadis E, Khaldi L, Melissaridou D, Iliopoulos ID,et al.Sex, but not age and bone mass index positively impact on the development of osteochondral micro-defects and the accompanying cellular alterations during osteoarthritis progression.Chronic Dis Transl Med. 2022 Mar 29;8(1):41-50. doi:10.1002/cdt3.16.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Findlay DM, Kuliwaba JS.Bone-cartilage crosstalk: a conversation for understanding osteoarthritis. Bone Res. 2016;4:16028. doi:10.1038/boneres.2016.28Li G, Yin J, Gao J, et al.Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes. Arthritis Res Ther. 2013;15(6):223. doi:10.1186/ar4405Huebner JL, Bay-Jensen AC, Huffman KM, et al.Alpha C-telopeptide of type I collagen is associated with subchondral bone turnover and predicts progression of joint space narrowing and osteophytes in osteoarthritis. Arthritis Rheumatol. 2014;66(9):2440-9. doi:10.1002/art.38739Huan C, Gao J.Insight into the potential pathogenesis of human osteoarthritis via single-cell RNA sequencing data on osteoblasts.Math Biosci Eng. 2022 Apr 20;19(6):6344-6361. doi:10.3934/mbe.2022297Roemer FW, Neogi T, Nevitt MC, et al.Subchondral bone marrow lesions are highly associated with, and predict subchondral bone attrition longitudinally: the MOST study. Osteoarthr Cartil. 2010;18(1):47-53. doi:10.1016/j.joca.2009.08.018Donell S.Subchondral bone remodelling in osteoarthritis. EFORT Open Rev. 2019;4(6):221-229. doi:10.1302/2058-5241.4.180102Kaspiris A, Chronopoulos E, Vasiliadis E, Khaldi L, Melissaridou D, Iliopoulos ID,et al.Sex, but not age and bone mass index positively impact on the development of osteochondral micro-defects and the accompanying cellular alterations during osteoarthritis progression.Chronic Dis Transl Med. 2022 Mar 29;8(1):41-50. doi:10.1002/cdt3.16.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Findlay DM, Kuliwaba JS.Bone-cartilage crosstalk: a conversation for understanding osteoarthritis. Bone Res. 2016;4:16028. doi:10.1038/boneres.2016.28Li G, Yin J, Gao J, et al.Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes. Arthritis Res Ther. 2013;15(6):223. doi:10.1186/ar4405Huebner JL, Bay-Jensen AC, Huffman KM, et al.Alpha C-telopeptide of type I collagen is associated with subchondral bone turnover and predicts progression of joint space narrowing and osteophytes in osteoarthritis. Arthritis Rheumatol. 2014;66(9):2440-9. doi:10.1002/art.38739Huan C, Gao J.Insight into the potential pathogenesis of human osteoarthritis via single-cell RNA sequencing data on osteoblasts.Math Biosci Eng. 2022 Apr 20;19(6):6344-6361. doi:10.3934/mbe.2022297Roemer FW, Neogi T, Nevitt MC, et al.Subchondral bone marrow lesions are highly associated with, and predict subchondral bone attrition longitudinally: the MOST study. Osteoarthr Cartil. 2010;18(1):47-53. doi:10.1016/j.joca.2009.08.018Donell S.Subchondral bone remodelling in osteoarthritis. EFORT Open Rev. 2019;4(6):221-229. doi:10.1302/2058-5241.4.180102Kaspiris A, Chronopoulos E, Vasiliadis E, Khaldi L, Melissaridou D, Iliopoulos ID,et al.Sex, but not age and bone mass index positively impact on the development of osteochondral micro-defects and the accompanying cellular alterations during osteoarthritis progression.Chronic Dis Transl Med. 2022 Mar 29;8(1):41-50. doi:10.1002/cdt3.16.
Findlay DM, Kuliwaba JS.Bone-cartilage crosstalk: a conversation for understanding osteoarthritis. Bone Res. 2016;4:16028. doi:10.1038/boneres.2016.28
Li G, Yin J, Gao J, et al.Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes. Arthritis Res Ther. 2013;15(6):223. doi:10.1186/ar4405
Huebner JL, Bay-Jensen AC, Huffman KM, et al.Alpha C-telopeptide of type I collagen is associated with subchondral bone turnover and predicts progression of joint space narrowing and osteophytes in osteoarthritis. Arthritis Rheumatol. 2014;66(9):2440-9. doi:10.1002/art.38739
Huan C, Gao J.Insight into the potential pathogenesis of human osteoarthritis via single-cell RNA sequencing data on osteoblasts.Math Biosci Eng. 2022 Apr 20;19(6):6344-6361. doi:10.3934/mbe.2022297
Roemer FW, Neogi T, Nevitt MC, et al.Subchondral bone marrow lesions are highly associated with, and predict subchondral bone attrition longitudinally: the MOST study. Osteoarthr Cartil. 2010;18(1):47-53. doi:10.1016/j.joca.2009.08.018
Donell S.Subchondral bone remodelling in osteoarthritis. EFORT Open Rev. 2019;4(6):221-229. doi:10.1302/2058-5241.4.180102
Kaspiris A, Chronopoulos E, Vasiliadis E, Khaldi L, Melissaridou D, Iliopoulos ID,et al.Sex, but not age and bone mass index positively impact on the development of osteochondral micro-defects and the accompanying cellular alterations during osteoarthritis progression.Chronic Dis Transl Med. 2022 Mar 29;8(1):41-50. doi:10.1002/cdt3.16.
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