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Bone Microdamage in Acute Knee Injury

Logeswaran Selvarajah1, Annie M Curtis2, Oran D Kennedy3

  • 1Department of Anatomy, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland. logesselva@rcsi.ie.

Current Rheumatology Reports
|November 23, 2018
PubMed
Abstract

Insights

Bone microdamage, particularly in the subchondral bone, is closely linked to bone marrow lesions (BMLs) after acute joint injury. This connection may explain subsequent joint degeneration and pain.

Area of Science:

  • Orthopedics
  • Bone Biology
  • Radiology

Background:

  • Bone tissue responds to microdamage through targeted remodeling.
  • Subchondral bone is susceptible to microdamage, especially after acute joint injury.
  • Bone marrow lesions (BMLs) are frequently observed via MRI following acute knee injuries.

Purpose of the Study:

  • To review the current understanding of bone tissue's response to microdamage.
  • To explore the relationship between subchondral microdamage and BMLs.
  • To discuss the implications for acute joint injury and subsequent joint degeneration.

Main Methods:

  • Literature review of studies on bone microdamage and BMLs.
  • Analysis of MRI findings in acute joint injuries.
  • Discussion of potential pathomechanisms linking microcracks and BMLs.

Main Results:

  • Microcracks in bone initiate osteocyte-mediated remodeling via RANKL expression.
  • Subchondral microcracks observed via MRI correlate spatially with BMLs.
  • BMLs are associated with joint pain and progressive structural joint degeneration.

Conclusions:

  • Subchondral microcracks are likely initiated during acute joint injury.
  • These microcracks are closely associated with clinically observed BMLs.
  • The link between microcracks and BMLs suggests a role in post-injury joint degeneration.
Keywords:
Bone marrow lesionCrosstalkJoint injuryMicrodamageSubchondral bone

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