eCM (Eur Cell Mater / e Cells & Materials) Not-for-profit Open Access
Created by Scientists, for Scientists
 ISSN:1473-2262         NLM:100973416 (link)         DOI:10.22203/eCM

2013   Volume No 25 – pages 299-316

Title: Alterations of the subchondral bone in osteochondral repair – translational data and clinical evidence

Author: P Orth, M Cucchiarini, D Kohn, H Madry

Address: Center of Experimental Orthopaedics, Saarland University, Kirrberger Strasse, Building 37, D-66421 Homburg, Germany

E-mail: henning.madry at

Key Words: Subchondral bone; microarchitecture; marrow stimulation; microfracture; subchondral drilling; abrasion arthroplasty.

Publication date: June 28th 2013

Abstract: Alterations of the subchondral bone are pathological features associated with spontaneous osteochondral repair following an acute injury and with articular cartilage repair procedures. The aim of this review is to discuss their incidence, extent and relevance, focusing on recent knowledge gained from both translational models and clinical studies of articular cartilage repair. Efforts to unravel the complexity of subchondral bone alterations have identified (1) the upward migration of the subchondral bone plate, (2) the formation of intralesional osteophytes, (3) the appearance of subchondral bone cysts, and (4) the impairment of the osseous microarchitecture as potential problems. Their incidence and extent varies among the different small and large animal models of cartilage repair, operative principles, and over time. When placed in the context of recent clinical investigations, these deteriorations of the subchondral bone likely are an additional, previously underestimated, factor that influences the long-term outcome of cartilage repair strategies. Understanding the role of the subchondral bone in both experimental and clinical articular cartilage repair thus holds great promise of being translated into further improved cell- or biomaterial-based techniques to preserve and restore the entire osteochondral unit.

Article download: Pages 299-316 (PDF file)
DOI: 10.22203/eCM.v025a21