On new bone formation in the pre-osteoarthritic joint

Abstract

Objective: This study investigated the structural alterations in the osteochondral junction, traversing the intact-to-lesion regions, with the aim of elucidating the way in which the pre-osteoarthritic (pre-OA) state progresses to fully developed osteoarthritis (OA).

Method: Thirty bovine patellae showing varying degrees of degeneration, with lesions located in the distal-lateral quarter, were used for this study. Cartilage-on-bone blocks were cut along the lateral facet to include both the lesion site in the distal end and the intact site in the proximal end. The blocks were formalin-fixed, mildly decalcified and microtomed to obtain 30 microm - thick osteochondral slices. Using differential interference contrast optics, the tissue microstructure was captured at high resolution in its fully hydrated state.

Results: There were structural changes in the osteochondral junction beneath the still-intact articular cartilage adjacent to the lesion site. The changes observed in traversing from the intact to the lesion site exhibited characteristics that were strikingly similar to those associated with primary bone formation. The evidence suggests that disruption of the cartilage continuum by a lesion has wider mechanobiological consequences at the osteochondral junction.

Conclusion: The progression of OA appears to involve new bone formation adjacent to lesion sites. We hypothesise that the new bone spicules that appear in regions beneath intact cartilage adjacent to lesion sites provide a snapshot of the elusive pre-OA state.