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  • Review Article
  • Published:

Changes in the osteochondral unit during osteoarthritis: structure, function and cartilage–bone crosstalk

Nature Reviews Rheumatology volume 12, pages 632–644 (2016)Cite this article

Subjects

Key Points

  • Osteoarthritis (OA) is a whole-joint disease in which all of the components of the joint are affected

  • The articular cartilage, subchondral bone, and calcified cartilage form an osteochondral biocomposite that is uniquely adapted to transferring loads during weight bearing and joint motion

  • Marked alterations in the composition, functional properties, and structure of the osteochondral tissues occur during the evolution of OA

  • Alteration in the composition or structure of any of the individual components of the osteochondral unit can initiate OA pathology in the joint

  • The differential capacity of bone and cartilage to adapt to the effects of local mechanical and environmental influences has an important role in the development of OA

  • Crosstalk between chondrocytes and bone cells contributes to OA pathogenesis

  • To develop rational therapies for OA, it is essential to have diagnostic tools to define the state of the components of the osteochondral unit

Abstract

In diarthrodial joints, the articular cartilage, calcified cartilage, and subchondral cortical and trabecular bone form a biocomposite — referred to as the osteochondral unit — that is uniquely adapted to the transfer of load. During the evolution of the osteoarthritic process the compositions, functional properties, and structures of these tissues undergo marked alterations. Although pathological processes might selectively target a single joint tissue, ultimately all of the components of the osteochondral unit will be affected because of their intimate association, and thus the biological and physical crosstalk among them is of great importance. The development of targeted therapies against the osteoarthritic processes in cartilage or bone will, therefore, require an understanding of the state of these joint tissues at the time of the intervention. Importantly, these interventions will not be successful unless they are applied at the early stages of disease before considerable structural and functional alterations occur in the osteochondral unit. This Review describes the changes that occur in bone and cartilage during the osteoarthritic process, and highlights strategies for how this knowledge could be applied to develop new therapeutic interventions for osteoarthritis.

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Figure 1: Structure of the normal knee joint and sequential changes in the osteochondral unit during the evolution of osteoarthritis.
Figure 2: Correlation of radiographic and structural changes in osteoarthritis.
Figure 3: Bone marrow lesions in osteoarthritis.

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Acknowledgements

The authors' work is supported by NIH grants R01-AG022021 (to M.B.G.) and RC4-AR060546 (to M.B.G.).

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    Steven R. Goldring & Mary B. Goldring

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Goldring, S., Goldring, M. Changes in the osteochondral unit during osteoarthritis: structure, function and cartilage–bone crosstalk. Nat Rev Rheumatol 12, 632–644 (2016). https://doi.org/10.1038/nrrheum.2016.148

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