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Curr Rheumatol Rep. 2018 Nov 21;20(12):89. doi: 10.1007/s11926-018-0791-8.

Bone Microdamage in Acute Knee Injury.

Author information

1
Department of Anatomy, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland. logesselva@rcsi.ie.
2
Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland.
3
Department of Anatomy, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland.

Abstract

PURPOSE OF REVIEW:

This review summarizes what is known about how bone tissue responds to microdamage, and how this applies to the subchondral region. This has significant relevance to acute joint injury, and is related to the occurrence of bone marrow lesions (BMLs) which are seen by MRI in 80% of acute knee joint injuries. Here, we review what is known about these phenomena (microcracks and BMLs) in the literature and discuss potential mechanisms by which they may be linked.

RECENT FINDINGS:

The recent findings in this field have shown that microcracks in bone initiate targeted remodeling via RANKL expression in osteocytes. Other work has shown that subchondral microcracks co-localize with BMLs as viewed by MRI. Finally, BMLs are associated with pain and structural joint degeneration. This paper demonstrates that subchondral microcracks likely occur during acute joint injury, and are closely linked to BML that are seem by clinical MRI and thus are potentially involved in the subsequent joint degeneration that occurs after injury.

KEYWORDS:

Bone marrow lesion; Crosstalk; Joint injury; Microdamage; Subchondral bone

PMID:
30465302
DOI:
10.1007/s11926-018-0791-8

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