Clinical, radiological, and histopathological evaluation of changes in cartilage and subchondral bone in patients with knee osteoarthritis

Year 2025, Volume: 42 Issue: 3, 290 - 295, 30.09.2025

Tolga Keçeci , Hasan Bombacı , Ayşe Özlem Balık , Fügen Vardar Aker

Abstract

This study investigates the interplay between cartilage degeneration and subchondral bone alterations including bone marrow lesions (BMLs) in patients with advanced knee osteoarthritis (OA), with a particular focus on the influence of body mass index (BMI). A total of 22 knees from 21 patients who underwent total knee arthroplasty were evaluated using a combination of clinical assessments, radiographic imaging, MRI, histopathology, and subchondral bone density measurements. The presence of BMLs did not correlate significantly with clinical scores or histological parameters. Notably, patients with BMI ≥30 demonstrated significantly lower subchondral bone density in the medial tibial plateau and greater histological cartilage degeneration in the lateral femoral condyle compared to those with BMI <30. These findings suggest that obesity may adversely affect subchondral bone integrity and cartilage quality in advanced OA, independent of clinical symptom severity. The results highlight the potential role of biomechanical and metabolic factors in modifying the osteoarthritic joint environment and underscore the need for further research integrating structural and functional biomarkers.

Keywords

Osteoarthritis knee , subchondral bone , body mass index , bone marrow lesions , cartilage degeneration

Ethical Statement

HNEAH KAEK 2017/86

Project Number

1

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