Klinische Aspekte des subchondralen Knochens bei der Arthrose

Zusammenfassung

Wissenschaftliche Erkenntnisse der letzten Jahrzehnte lassen vermuten, dass Veränderungen im Bereich des subchondralen Knochens in der Genese und Progression der Arthrose mitverantwortlich sind. Vordergründig scheinen hierfür mechanische Faktoren wie Achsfehlstellung und Instabilität verantwortlich. Die Veränderungen im subchondralen Knochen sind biphasisch. Primär kommt es durch ein erhöhtes Remodeling zu einer Reduktion des Knochenvolumens im Bereich des subchondralen Knochen, sekundär zu einer Dichtezunahme und Abnahme der Gewebsmineralisation. Die veränderten strukturellen Gegebenheiten des Knochens begünstigen die Progression der Knorpeldegeneration. Medikamente, die das Bone Remodeling beeinflussen, werden daher auch als potenzielle Behandlungsoptionen für die Arthrose betrachtet.

Abstract

Scientific data of the last decades show that subchondral bone changes are involved in the initiation and progression of osteoarthritis. Mechanical factors such as mal-alignment and instability seem to be primarily responsible. Initially remodeling of the subchondral bone is increased and bone volume decreased, whereas in a secondary stage bone density is increased and the degree of tissue mineralization is decreased. These structural changes of the bone lead to a further progession of cartilage degradation. Drugs that affect bone remodeling are therefore seen as potential treatment options of osteoarthritis.

Schlüsselwörter

Subchondraler Knochen - Osteochondrale Einheit - Arthrose - Medikamentöse Therapie

Key words

Subchondral Bone - Osteochondral Unit - Osteoarthritis - Pharmacological Therapy

Publication History

Article published online:
03 February 2021

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