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Bone Marrow Lesions in Osteoarthritis: What Lies Beneath

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posted on 08.07.2020 by Tamara Alliston, Christopher J. Hernandez, David M Findlay, David T. Felson, Oran Kennedy
Osteoarthritis (OA) is the most common joint disease in the United States, affecting more than 30 million people, and is characterized by cartilage degeneration in articulating joints. OA can be viewed as a group of overlapping disorders, which result in functional joint failure. However, the precise cellular and molecular events within which lead to these clinically observable changes are neither well understood nor easily measurable. It is now clear that multiple factors, in multiple joint tissues, contribute to degeneration. Changes in subchondral bone are recognized as a hallmark of OA, but are normally associated with late-stage disease when degeneration is well established. However, early changes such as Bone Marrow Lesions (BMLs) in OA are a relatively recent discovery. BMLs are patterns from magnetic resonance images (MRI) that have been linked with pain and cartilage degeneration. Their potential utility in predicting progression, or as a target for therapy, is not yet fully understood. Here, we will review the current state-of-the-art in this field under three broad headings: (i) BMLs in symptomatic OA: malalignment, joint pain, and disease progression; (ii) biological considerations for bone-cartilage crosstalk in joint disease; and (iii) mechanical factors that may underlie BMLs and drive their communication with other joint tissues. Thus, this review will provide insights on this topic from a clinical, biological, and mechanical perspective.

Funding

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 799283 (ODK)

History

Comments

This is the peer reviewed version of the following article: Alliston T, Hernandez CJ, Findlay DM, Felson DT, Kennedy OD. Bone Marrow Lesions in Osteoarthritis: What Lies Beneath. Journal of Orthopaedic Research. 2018;36(7):1818-1825, which has been published in final form at https://doi.org/10.1002/jor.23844. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

Published Citation

Alliston T, Hernandez CJ, Findlay DM, Felson DT, Kennedy OD. Bone Marrow Lesions in Osteoarthritis: What Lies Beneath. Journal of Orthopaedic Research. 2018;36(7):1818-1825

Publication Date

22/05/2018

PubMed ID

29266428

Department/Unit

  • Anatomy and Regenerative Medicine

Publisher

Wiley Publishing

Version

  • Accepted Version (Postprint)

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