A nosographic and etiopathogenetic framework for subchondral bone marrow lesions in the knee: A narrative review
Abstract Purpose Subchondral bone marrow lesions (BMLs) are present in a wide range of pathologies with different prognoses. Thus, a careful diagnosis is mandatory to address them with the proper treatment. The aim of this review was to examine BMLs aetiology and their relationship with biomechanica...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | Journal of Experimental Orthopaedics |
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| Online Access: | https://doi.org/10.1002/jeo2.70071 |
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| author | Luca Andriolo Alessandro Sangiorgio Anthony Galea Eran Linder‐Ganz Patrick Orth Nogah Shabshin Takuaki Yamamoto Giuseppe Filardo |
| author_facet | Luca Andriolo Alessandro Sangiorgio Anthony Galea Eran Linder‐Ganz Patrick Orth Nogah Shabshin Takuaki Yamamoto Giuseppe Filardo |
| author_sort | Luca Andriolo |
| collection | DOAJ |
| description | Abstract Purpose Subchondral bone marrow lesions (BMLs) are present in a wide range of pathologies with different prognoses. Thus, a careful diagnosis is mandatory to address them with the proper treatment. The aim of this review was to examine BMLs aetiology and their relationship with biomechanical and biological factors, to identify BMLs and help clinicians to properly recognize and treat each of these common alterations. Discussion Each pathological pattern is determined by different aetiologic factors, which may act alone or synergically in determining the BML. These factors include major or minor trauma, bone tissue alterations, altered joint load distribution, coagulopathies, and hormonal alterations. This narrative review encompasses these patterns and factors providing a nosographic and etiopathogenetic framework for subchondral BMLs in the knee. Conclusion While the field is still heterogeneous in the definition of the nosographic framework of BMLs, there is a trend with the convergence towards a common terminology, which could help to shed more light on the complex and varied field of BMLs. Future studies should focus on better understanding the etiopathogenetic mechanisms, which can concur with the development of BML from one side, and, on the other hand, may represent targets for future treatments to address BMLs and preserve or restore the osteochondral unit. Level of Evidence Expert Opinion, Level V. |
| format | Article |
| id | doaj-art-eaf4d34020e3473aa96b1848cb8f0459 |
| institution | OA Journals |
| issn | 2197-1153 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj-art-eaf4d34020e3473aa96b1848cb8f04592025-08-20T02:26:06ZengWileyJournal of Experimental Orthopaedics2197-11532025-01-01121n/an/a10.1002/jeo2.70071A nosographic and etiopathogenetic framework for subchondral bone marrow lesions in the knee: A narrative reviewLuca Andriolo0Alessandro Sangiorgio1Anthony Galea2Eran Linder‐Ganz3Patrick Orth4Nogah Shabshin5Takuaki Yamamoto6Giuseppe Filardo7Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli Bologna ItalyService of Orthopaedics and Traumatology, Department of Surgery EOC Lugano SwitzerlandIHM Clinics Toronto Ontario CanadaActive Implants Netanya IsraelDepartment of Orthopaedic Surgery Saarland University Medical Center Homburg/Saar GermanyDepartment of Radiology Carmel Medical Center Haifa IsraelDepartment of Orthopedic Surgery Fukuoka University Faculty of Medicine Fukuoka JapanService of Orthopaedics and Traumatology, Department of Surgery EOC Lugano SwitzerlandAbstract Purpose Subchondral bone marrow lesions (BMLs) are present in a wide range of pathologies with different prognoses. Thus, a careful diagnosis is mandatory to address them with the proper treatment. The aim of this review was to examine BMLs aetiology and their relationship with biomechanical and biological factors, to identify BMLs and help clinicians to properly recognize and treat each of these common alterations. Discussion Each pathological pattern is determined by different aetiologic factors, which may act alone or synergically in determining the BML. These factors include major or minor trauma, bone tissue alterations, altered joint load distribution, coagulopathies, and hormonal alterations. This narrative review encompasses these patterns and factors providing a nosographic and etiopathogenetic framework for subchondral BMLs in the knee. Conclusion While the field is still heterogeneous in the definition of the nosographic framework of BMLs, there is a trend with the convergence towards a common terminology, which could help to shed more light on the complex and varied field of BMLs. Future studies should focus on better understanding the etiopathogenetic mechanisms, which can concur with the development of BML from one side, and, on the other hand, may represent targets for future treatments to address BMLs and preserve or restore the osteochondral unit. Level of Evidence Expert Opinion, Level V.https://doi.org/10.1002/jeo2.70071bone marrow lesionskneeosteoarthritissubchondral bone |
| spellingShingle | Luca Andriolo Alessandro Sangiorgio Anthony Galea Eran Linder‐Ganz Patrick Orth Nogah Shabshin Takuaki Yamamoto Giuseppe Filardo A nosographic and etiopathogenetic framework for subchondral bone marrow lesions in the knee: A narrative review Journal of Experimental Orthopaedics bone marrow lesions knee osteoarthritis subchondral bone |
| title | A nosographic and etiopathogenetic framework for subchondral bone marrow lesions in the knee: A narrative review |
| title_full | A nosographic and etiopathogenetic framework for subchondral bone marrow lesions in the knee: A narrative review |
| title_fullStr | A nosographic and etiopathogenetic framework for subchondral bone marrow lesions in the knee: A narrative review |
| title_full_unstemmed | A nosographic and etiopathogenetic framework for subchondral bone marrow lesions in the knee: A narrative review |
| title_short | A nosographic and etiopathogenetic framework for subchondral bone marrow lesions in the knee: A narrative review |
| title_sort | nosographic and etiopathogenetic framework for subchondral bone marrow lesions in the knee a narrative review |
| topic | bone marrow lesions knee osteoarthritis subchondral bone |
| url | https://doi.org/10.1002/jeo2.70071 |
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