Bone marrow lesions in osteoarthritis: From basic science to clinical implications
Xiaorui Shi,
Yiying Mai,
Xiaofeng Fang,
Zhiqiang Wang,
Song Xue,
Haowei Chen,
Qin Dang,
Xiaoshuai Wang,
Su'an Tang,
Changhai Ding,
Zhaohua Zhu
Affiliations
Xiaorui Shi
Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Yiying Mai
Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China; Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Xiaofeng Fang
Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Zhiqiang Wang
Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Song Xue
Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Haowei Chen
Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Qin Dang
Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Xiaoshuai Wang
Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Su'an Tang
Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Changhai Ding
Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Department of Orthopedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
Zhaohua Zhu
Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Corresponding author at: Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Osteoarthritis (OA) is the most prevalent musculoskeletal disease characterized by multiple joint structure damages, including articular cartilage, subchondral bone and synovium, resulting in disability and economic burden. Bone marrow lesions (BMLs) are common and important magnetic resonance imaging (MRI) features in OA patients. Basic and clinical research on subchondral BMLs in the pathogenesis of OA has been a hotspot. New evidence shows that subchondral bone degeneration, including BML and angiogenesis, occurs not only at or after cartilage degeneration, but even earlier than cartilage degeneration. Although BMLs are recognized as important biomarkers for OA, their exact roles in the pathogenesis of OA are still unclear, and disputes about the clinical impact and treatment of BMLs remain. This review summarizes the current basic and clinical research progress of BMLs. We particularly focus on molecular pathways, cellular abnormalities and microenvironmental changes of subchondral bone that contributed to the formation of BMLs, and emphasize the crosstalk between subchondral bone and cartilage in OA development. Finally, potential therapeutic strategies targeting BMLs in OA are discussed, which provides novel strategies for OA treatment.
