Abstract
Subchondral bone cysts represent an early postoperative sign associated with many articular cartilage repair procedures. They may be defined as an abnormal cavity within the subchondral bone in close proximity of a treated cartilage defect with a possible communication to the joint cavity in the absence of osteoarthritis. Two synergistic mechanisms of subchondral cyst formation, the theory of internal upregulation of local proinflammatory factors, and the external hydraulic theory, are proposed to explain their occurrence. This review describes subchondral bone cysts in the context of articular cartilage repair to improve investigations of these pathological changes. It summarizes their epidemiology in both preclinical and clinical settings with a focus on individual cartilage repair procedures, examines an algorithm for subchondral bone analysis, elaborates on the underlying mechanism of subchondral cyst formation, and condenses the clinical implications and perspectives on subchondral bone cyst formation in cartilage repair.
Highlights
Graphical AbstractSubchondral bone cysts commonly occur adjacent to a treated focal cartilage defect and are possibly connected to the joint cavity
Articular cartilage, the resilient and flexible connective tissue covering the articulating surfaces of joints, has a limited regenerative capacity.[1]
We propose to define a subchondral bone cyst associated with cartilage repair as an abnormal cavity within the subchondral bone in close proximity of a cartilage defect with a possible communication to the joint cavity, in the absence of OA
Summary
Subchondral bone cysts commonly occur adjacent to a treated focal cartilage defect and are possibly connected to the joint cavity. A radiographic-based algorithm allows for a detailed analysis of postoperative subchondral bone cysts and other alterations of the subchondral bone. Formation of subchondral bone cysts might result from synergistic effects of both external and internal contributors. Funding Information: Saarland University within the funding programme Open Access Publishing
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