{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T21:06:57Z","timestamp":1793653617710,"version":"4.5.1"},"reference-count":36,"publisher":"Bioscientifica","issue":"6","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":2449,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Subchondral bone remodelling is an integral part of osteoarthritis and involves the development of subchondral sclerosis seen on plain imaging, along with osteophyte formation. The development of these changes is due to persistent abnormal mechanical stresses which create a cellular and biomolecular response to microfractures in the subchondral bone and osteochondral junction. An early sign is bone marrow lesions seen on MRI scanning. Healing can occur at this stage by correcting the abnormal loads. Persistence leads to what is thought to be a delayed union or nonunion response by the bone. Microfractures of the osteochondral junction, coupled with articular cartilage fissuring and loss, allows synovial fluid to penetrate the subchondral bone along with cytokines and other molecules reacting with the bone cells to increase the pathological effects. This review gives an overview of the current thoughts on subchondral bone remodelling in osteoarthritis that is aimed at orthopaedic surgeons to help in the understanding of the pathogenesis of osteoarthritis and the role of surgical management.<\/jats:p>\n                  <jats:p>Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302\/2058-5241.4.180102<\/jats:p>","DOI":"10.1302\/2058-5241.4.180102","type":"journal-article","created":{"date-parts":[[2019,6,3]],"date-time":"2019-06-03T06:35:41Z","timestamp":1559543741000},"page":"221-229","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":204,"title":["Subchondral bone remodelling in osteoarthritis"],"prefix":"10.1530","volume":"4","author":[{"given":"Simon","family":"Donell","sequence":"first","affiliation":[{"name":"1University of East Anglia, Faculty of Medicine and Health Sciences - Norwich Medical School, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2019,6,3]]},"reference":[{"key":"2026070711252905300_bibr1-2058-5241.4.180102","article-title":"Do immune cells lead the way in subchondral bone disturbance in osteoarthritis?","author":"Weber","year":"2017","journal-title":"Prog Biophys Mol Biol"},{"key":"2026070711252905300_bibr2-2058-5241.4.180102","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1016\/j.joca.2018.04.018","article-title":"Defining the osteoarthritis patient: back to the future","volume":"26","author":"Dobson","year":"2018","journal-title":"Osteoarthritis Cartilage"},{"key":"2026070711252905300_bibr3-2058-5241.4.180102","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1016\/j.joca.2018.05.007","article-title":"Comparison of histological and morphometrical changes underlying subchondral bone abnormalities in inflammatory and degenerative musculoskeletal disorders: a systematic review","volume":"26","author":"Loef","year":"2018","journal-title":"Osteoarthritis Cartilage"},{"key":"2026070711252905300_bibr4-2058-5241.4.180102","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.bone.2018.01.012","article-title":"Bone matrix microdamage and vascular changes characterize bone marrow lesions in the subchondral bone of knee osteoarthritis","volume":"108","author":"Muratovic","year":"2018","journal-title":"Bone"},{"key":"2026070711252905300_bibr5-2058-5241.4.180102","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.bone.2011.10.010","article-title":"Osteochondral alterations in osteoarthritis","volume":"51","author":"Suri","year":"2012","journal-title":"Bone"},{"key":"2026070711252905300_bibr6-2058-5241.4.180102","article-title":"The genetic association between asporin and osteoarthritis","volume":"15","author":"Clark","year":"2008","journal-title":"Knee"},{"key":"2026070711252905300_bibr7-2058-5241.4.180102","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1002\/art.11433","article-title":"Expression profiling of metalloproteinases and their inhibitors in cartilage","volume":"50","author":"Kevorkian","year":"2004","journal-title":"Arthritis Rheum"},{"key":"2026070711252905300_bibr8-2058-5241.4.180102","doi-asserted-by":"crossref","first-page":"1674","DOI":"10.1038\/nm.2543","article-title":"Identification of a central role for complement in osteoarthritis","volume":"17","author":"Wang","year":"2011","journal-title":"Nat Med"},{"key":"2026070711252905300_bibr9-2058-5241.4.180102","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1038\/nm.2146","article-title":"Transcriptional regulation of endochondral ossification by HIF-2alpha during skeletal growth and osteoarthritis development","volume":"16","author":"Saito","year":"2010","journal-title":"Nat Med"},{"key":"2026070711252905300_bibr10-2058-5241.4.180102","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1038\/nm.2153","article-title":"Hypoxia-inducible factor-2alpha is a catabolic regulator of osteoarthritic cartilage destruction","volume":"16","author":"Yang","year":"2010","journal-title":"Nat Med"},{"key":"2026070711252905300_bibr11-2058-5241.4.180102","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1038\/nm.3143","article-title":"Inhibition of TGF\u2013\u03b2 signaling in mesenchymal stem cells of subchondral bone attenuates osteoarthritis","volume":"19","author":"Zhen","year":"2013","journal-title":"Nat Med"},{"key":"2026070711252905300_bibr12-2058-5241.4.180102","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1016\/j.joca.2017.02.791","article-title":"ADAMTS and ADAM metalloproteinases in osteoarthritis - looking beyond the \u2018usual suspects\u2019","volume":"25","author":"Yang","year":"2017","journal-title":"Osteoarthritis Cartilage"},{"key":"2026070711252905300_bibr13-2058-5241.4.180102","first-page":"1461","article-title":"What drives osteoarthritis? 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