Abstract
Role of subchondral bone in the natural healing of the cartilage has been largely ignored during the last few decades; whereas the cartilage repair science evolved continuously. Clinicians and scientists were aware of the various properties of the subchondral bone; like nutrition to the cartilage, load sharing with the cartilage and as a constant supplier of chondroblasts, pluripotent cells and the growth factors to the cartilage. Various conditions like osteochondritis dissecans, osteonecrosis, bone marrow oedema in chondral injuries etc constantly indicated that the subchondral bone and the cartilage are one single unit-the osteochondral unit. However, there was an unintended neglect about the role of these important properties of the subchondral bone in the natural repair of the cartilage. The subchondral bone and the overlying cartilage, work as one integral unit and help each other in maintaining the biomechanical equilibrium. The relation between both the components is like a soil-plant relationship where none can survive without the other part. A proper attention to the subchondral bone is thus important to maintain a healthy cartilaginous tissue under physiological stresses and to regenerate a healthy cartilage in case of the cartilage damage.
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Madry H, Dijk CN, Mueller-Gerbl M. The basic science of the subchondral bone. Knee Surg Sports Traumatol Arthrosc. 2010;18(4):419–33.
Brittberg M. Autologous chondrocyte implantation–technique and long-term follow-up. Injury. 2008;39(Suppl 1):S40–9.
Gomoll AH, Madry H, Knutsen G, et al. The subchondral bone in articular cartilage repair: current problems in the surgical management. Knee Surg Sports Traumatol Arthrosc. 2010;18(4):434–47.
Imhof H, Breitenseher M, Kainberger F, Rand T, Trattnig S. Importance of subchondral bone to articular cartilage in health and disease. Top Magn Reson Imaging. 1999;10(3):180–92.
Fisher AGT. Chronic (non-tuberculous) arthritis. London: HK Lewis; 1929.
Berry JL, Thaeler-Oberdoerster DA, Greenwald AS. Subchondral pathways to the superior surface of the human talus. Foot Ankle. 1986;7:2–9.
Nakano T, Thompson JR, Christopherson RJ, Aherne FX. Blood flow distribution in hind limb bones and joint cartilage from young growing pigs. Can J Vet Res. 1986;50(1):96–100.
Lyons TJ, McClure SF, Stoddart RW, McClure J. The normal human chondro-osseous junctional region: evidence for contact of uncalcified cartilage with subchondral bone and marrow spaces. BMC Musculoskelet Disord. 2006;7:52.
Pan J, Zhou X, Li W, Novotny JE, Doty SB, Wang L. In situ measurement of transport between subchondral bone and articular cartilage. J Orthop Res. 2009;27(10):1347–52.
Lane LB, Villacin A, Bullough PG. The vascularity and remodelling of subchondrial bone and calcified cartilage in adult human femoral and humeral heads. An age- and stress-related phenomenon. J Bone Joint Surg Br. 1977;59(3):272–8.
Hoechel S, Wirz D, Müller-Gerbl M. Density and strength distribution in the human subchondral bone plate of the patella. Int Orthop. 2012;36(9):1827–34.
Milz S, Putz R. Quantitative morphology of the subchondral plate of the tibial plateau. J Anat. 1994;185(Pt 1):103–10.
Salsich GB, Ward SR, Terk MR, Powers CM. In vivo assessment of patellofemoral joint contact area in individuals who are pain free. Clin Orthop Relat Res. 2003;417:277–84.
Kraljević M, Zumstein V, Wirz D, Hügli R, Müller-Gerbl M. Mineralisation and mechanical strength of the glenoid cavity subchondral bone plate. Int Orthop. 2011;35(12):1813–9.
Muller-Gerbl M, Dalstra M, Ding M, Linsenmeier U, Putz R, Hvid I. Distribution of strength and mineralization in the subchondral bone plate of human tibial heads. J Biomech. 1998;31(Suppl 1):123. Proceedings of the 11th conference of the European society of biomechanics.
Egloff C, Paul J, Pagenstert G, et al. Changes of density distribution of the subchondral bone plate after supramalleolar osteotomy for valgus ankle osteoarthritis. J Orthop Res. 2014;32(10):1356–61.
Milz S, Eckstein F, Putz R. The thickness of the subchondral plate and its correlation with the thickness of the uncalcified articular cartilage in the human patella. Anat Embryol (Berl). 1995;192:437–44.
Qiu Y-S, Shahgaldi BF, Revell WJ, Heatley FW. Observations of subchondral plate advancement during osteochondral repair: a histomorphometric and mechanical study in the rabbit femoral condyle. Osteoarthr Cartil. 2003;11(11):810-820.
Orth P, Goebel L, Wolfram U, et al. Effect of subchondral drilling on the microarchitecture of subchondral bone: analysis in a large animal model at 6 months. Am J Sports Med. 2012;40(4):828–36.
Goyal D, Keyhani S, Lee EH, Hui JHP. Evidence-based status of microfracture technique: a systematic review of level I and II studies. Arthroscopy. 2013;29(9):1579–88.
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Goyal, D., Goyal, A., Adachi, N. (2017). Subchondral Bone: Healthy Soil for the Healthy Cartilage. In: Gobbi, A., Espregueira-Mendes, J., Lane, J., Karahan, M. (eds) Bio-orthopaedics. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54181-4_38
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DOI: https://doi.org/10.1007/978-3-662-54181-4_38
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