Subchondral bone remodeling patterns in larger animal models of meniscal injuries inducing knee osteoarthritis – a systematic review

Oláh, Tamás; Cucchiarini, Magali; Madry, Henning

doi:10.1007/s00167-023-07579-6

Cited by 4 publications

(2 citation statements)

References 53 publications

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“…This hypothesis, which has previously been discussed in the literature but not yet supported with data from comparable, controlled study cohorts, has now been supported for the first time by the present study [18,37]. This may be due to the adequate reconstruction of the biomechanically important subchondral layer in patients treated with M-ACI and ABG [9,28]. However, the present study lacks MRI data to support this assumption.…”

Section: Discussionsupporting

confidence: 66%

The role of autologous bone grafting in matrix‐associated autologous chondrocyte implantation at the knee: Results from the German Cartilage Registry (KnorpelRegister DGOU)

Weishorn,

Tischer,

Niemeyer

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeTo investigate whether concomitant autologous bone grafting adversely affects clinical outcome and graft survival after matrix‐associated autologous chondrocyte implantation (M‐ACI).MethodsThe present study examines registry data of patients who underwent M‐ACI with or without autologous bone grafting for large‐sized chondral or osteochondral defects. Propensity score matching was performed to exclude potential confounders. A total of 215 patients with similar baseline characteristics were identified. Clinical outcome was assessed at the time of surgery and at 6, 12, 24, 36 and 60 months using the Knee Injury and Osteoarthritis Outcome Score (KOOS). KOOS change, clinical response rate, KOOS subcomponents and failure rate were determined.ResultsPatients treated with M‐ACI and autologous bone grafting achieved comparable clinical outcomes compared with M‐ACI alone. At 24 months postoperatively, the patient‐reported outcome (PRO) of patients treated with M‐ACI and autologous bone grafting was even significantly better as measured by KOOS (74.9 ± 18.8 vs. 79.2 ± 15.4; p = 0.043). However, the difference did not exceed the minimal clinically important difference (MCID). In patients with M‐ACI and autologous bone grafting, a greater change in KOOS relative to baseline was observed at 6 (9.3 ± 14.7 vs. 15.0 ± 14.7; p = 0.004) and 12 months (12.6 ± 17.2 vs. 17.7 ± 14.6; p = 0.035). Overall, a high clinical response rate was observed in both groups at 24 months (75.8% vs. 82.0%; p = n.s.). The estimated survival at the endpoint of reoperation for any reason was 82.1% (SD 2.8) at 8.4 years for isolated M‐ACI and 88.7% (SD 2.4) at 8.2 years for M‐ACI with autologous bone grafting (p = 0.039).ConclusionsEven in the challenging cohort of large osteochondral defects, the additional treatment with autologous bone grafting leads to remarkably good clinical outcomes in patients treated with M‐ACI. In fact, they tend to benefit more from surgery, have lower revision rates and achieve clinical response rates earlier. Subchondral bone management is critical to the success of M‐ACI and should be addressed in the treatment of borderline defects.Level of EvidenceLevel III.

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Section: Discussionsupporting

confidence: 66%

The role of autologous bone grafting in matrix‐associated autologous chondrocyte implantation at the knee: Results from the German Cartilage Registry (KnorpelRegister DGOU)

Weishorn,

Tischer,

Niemeyer

et al. 2024

Knee surg. sports traumatol. arthrosc.

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“…OA causes substantial changes in bone density and microstructure in the joint microenvironment [61]. In early-stage OA, the subchondral bone plate undergoes thinning and increased porosity concomitant with initial cartilage degeneration.…”

Section: Subchondral Microenvironment Of Osteoarthritismentioning

confidence: 99%

Osteoporosis, Osteoarthritis, and Subchondral Insufficiency Fracture: Recent Insights

Yokota,

Ishizu,

Miyazaki

et al. 2024

Biomedicines

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The increased incidence of osteoarthritis (OA), particularly knee and hip OA, and osteoporosis (OP), owing to population aging, have escalated the medical expense burden. Osteoarthritis is more prevalent in older women, and the involvement of subchondral bone fragility spotlights its association with OP. Notably, subchondral insufficiency fracture (SIF) may represent a more pronounced condition of OA pathophysiology. This review summarizes the relationship between OA and OP, incorporating recent insights into SIF. Progressive SIF leads to joint collapse and secondary OA and is associated with OP. Furthermore, the thinning and fragility of subchondral bone in early-stage OA suggest that SIF may be a subtype of OA (osteoporosis-related OA, OPOA) characterized by significant subchondral bone damage. The high bone mineral density observed in OA may be overestimated due to osteophytes and sclerosis and can potentially contribute to OPOA. The incidence of OPOA is expected to increase along with population aging. Therefore, prioritizing OP screening, early interventions for patients with early-stage OA, and fracture prevention measures such as rehabilitation, fracture liaison services, nutritional management, and medication guidance are essential.

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Advancements in Subchondral Bone Biomechanics: Insights from Computed Tomography and Micro-Computed Tomography Imaging in Equine Models

Malekipour,

Whitton,

Lee

2024

Curr Osteoporos Rep

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Purpose of Review This review synthesizes recent advancements in understanding subchondral bone (SCB) biomechanics using computed tomography (CT) and micro-computed tomography (micro-CT) imaging in large animal models, particularly horses. Recent Findings Recent studies highlight the complexity of SCB biomechanics, revealing variability in density, microstructure, and biomechanical properties across the depth of SCB from the joint surface, as well as at different joint locations. Early SCB abnormalities have been identified as predictive markers for both osteoarthritis (OA) and stress fractures. The development of standing CT systems has improved the practicality and accuracy of live animal imaging, aiding early diagnosis of SCB pathologies. Summary While imaging advancements have enhanced our understanding of SCB, further research is required to elucidate the underlying mechanisms of joint disease and articular surface failure. Combining imaging with mechanical testing, computational modelling, and artificial intelligence (AI) promises earlier detection and better management of joint disease. Future research should refine these modalities and integrate them into clinical practice to enhance joint health outcomes in veterinary and human medicine.

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Subchondral bone remodeling patterns in larger animal models of meniscal injuries inducing knee osteoarthritis – a systematic review

Cited by 4 publications

References 53 publications

The role of autologous bone grafting in matrix‐associated autologous chondrocyte implantation at the knee: Results from the German Cartilage Registry (KnorpelRegister DGOU)

The role of autologous bone grafting in matrix‐associated autologous chondrocyte implantation at the knee: Results from the German Cartilage Registry (KnorpelRegister DGOU)

Osteoporosis, Osteoarthritis, and Subchondral Insufficiency Fracture: Recent Insights

Advancements in Subchondral Bone Biomechanics: Insights from Computed Tomography and Micro-Computed Tomography Imaging in Equine Models

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