Bio-orthopaedics pp 479-486
Subchondral Bone: Healthy Soil for the Healthy Cartilage
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Role of subchondral bone in the natural healing of the cartilage has been largely ignored during the last few decades; whereas the cartilage repair science evolved continuously. Clinicians and scientists were aware of the various properties of the subchondral bone; like nutrition to the cartilage, load sharing with the cartilage and as a constant supplier of chondroblasts, pluripotent cells and the growth factors to the cartilage. Various conditions like osteochondritis dissecans, osteonecrosis, bone marrow oedema in chondral injuries etc constantly indicated that the subchondral bone and the cartilage are one single unit-the osteochondral unit. However, there was an unintended neglect about the role of these important properties of the subchondral bone in the natural repair of the cartilage. The subchondral bone and the overlying cartilage, work as one integral unit and help each other in maintaining the biomechanical equilibrium. The relation between both the components is like a soil-plant relationship where none can survive without the other part. A proper attention to the subchondral bone is thus important to maintain a healthy cartilaginous tissue under physiological stresses and to regenerate a healthy cartilage in case of the cartilage damage.
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