Should subchondral bone turnover be targeted when treating osteoarthritis?

/Home/Chiropractic Treatment for Other Symptoms/Chiropractic Treatment-Degenerative Joint Disease/Degenerative Joint Disease Research

You will need to copy and paste the URL into a browser to view the abstract; a subscription is required to view the full text or it can be purchased online.

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WP3-4S4BHB0-1&_user=10&_coverDate=06%2F30%2F2008&_rdoc=3&_fmt=high&_orig=browse&_srch=doc-info(%23toc%236979%232008%23999839993%23691460%23FLA%23display%23Volume)&_cdi=6979&_sort=d&_docanchor=&_ct=14&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=c2082ddc416e96616a59c3caf32c7bd2

Should subchondral bone turnover be targeted when treating osteoarthritis?
Osteoarthritis and Cartilage
Volume 16, Issue 6, June 2008, Pages 638-646

M.A. Karsdal M.Sc., Ph.D.‹, D.J. Leeming M.Sc.‹, E.B. Dam M.Sc., Ph.D.‹, K. Henriksen M.Sc., Ph.D.‹, P. Alexandersen M.Sc., Ph.D.·, P. Pastoureau Ph.D.?, R.D. Altman M.D.short parallel and C. Christiansen M.D.‹
‹Nordic Bioscience A/S, Herlev, Denmark
·Center for Clinical and Basic Research, Ballerup Byvej 222, Ballerup, Denmark ||David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, USA
?Institut de Recherche Servier (IdRS), Paris, France

Received 10 October 2007;
accepted 18 January 2008.
Available online 24 March 2008.

Summary
Objective
Osteoarthritis (OA) is the most common form of arthritic disease, and it is a major cause of disability and impaired quality of life in the elderly. OA is a complex disease of the entire joint, including bone and cartilage, thereby presenting alternative approaches for treatment. This review summarizes emerging observations from cell biology to preliminary clinical trials, describing interactions between the bone and cartilage components. We speculate whether a treatment for OA would be possible without targeting the bone compartment?

Methods
Peer-reviewed articles found using pre-defined search criteria and published in the PubMed database until June 2007 are summarized. In addition, abstracts from the OsteoArthritis Research Society International (OARSI) conferences in the time period 2000̉2007 were included.

Results
Bone and cartilage health seem to be tightly associated. Ample evidence is found for bone changes during progression of OA, including, but not limited to, increased turnover in the subchondral bone, thinning of the trabecular structure, osteophytes, bone marrow lesions and sclerosis of the subchondral plate. In addition, a range of investigations has described secondary positive effects on cartilage health when bone resorption was suppressed, or deterioration of the cartilage when resorption is increased.

Conclusion
An optimal treatment for OA might include targeting both the bone and cartilage compartments. Hence, as several cell systems are to be targeted in a safe manner, limited options seem possible.

Key words: Osteoarthritis; Osteoclasts; Chondrocytes; Bone; Cartilage; Turnover; Sclerosis; Subchondral; Phenotype