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

Area of Science:

• Orthopedics
• Rheumatology
• Biomaterials Science

Background:

• Diarthrodial joints feature an osteochondral unit comprising cartilage and bone, adapted for load transfer.
• Osteoarthritis (OA) involves significant alterations in the composition, function, and structure of these tissues.
• The interconnectedness of the osteochondral unit means all components are affected by OA, highlighting the importance of biological and physical crosstalk.

Purpose of the Study:

• To review the structural and functional changes in bone and cartilage during osteoarthritis.
• To explore how understanding these tissue alterations can inform the development of novel therapeutic interventions for OA.
• To emphasize the critical need for early intervention in OA treatment.

Main Methods:

• This review synthesizes current knowledge on the osteoarthritic process affecting the osteochondral unit.
• It analyzes the biological and physical interactions between cartilage and bone during OA.
• Strategies for applying this knowledge to therapeutic development are highlighted.

Main Results:

• Osteoarthritis induces progressive and widespread changes throughout the osteochondral unit.
• The intimate association between cartilage and bone necessitates a holistic approach to understanding OA pathology.
• Early-stage interventions are more likely to be successful before substantial tissue degradation occurs.

Conclusions:

• Targeted therapies for OA require a comprehensive understanding of the osteochondral unit's condition.
• Interventions must be applied early in the disease process for optimal efficacy.
• Future OA treatments may leverage insights into the crosstalk between bone and cartilage.