Turkish Journal of Geriatrics 2011 , Vol 14 (Supplement)
Şişli Etfal Eğitim Araştırma Hastanesi Fiziksel Tıp ve Rehabilitasyon Kliniği, İSTANBUL Osteoarthritis (OA) is an “organ disease” that includes cartilage degeneration, mineralisation differences in subchondral bone, synovial and soft tissue changes. Pathogenesis and treatment approaches have been mainly focused on the disorders of the articular cartilage . Subchondral bone provides a mechanical base for the subchondral bone and also provides it with nutrients. The hypothesis that bone remodeling in the subchondral plate and trabecular bone below it preceeds cartilage degeneration has prioritised the subchondral bone in the pathogenesis of OA. Increase in the synthesis of osteoid tissue, hypomineralisation of this newly formed matrix, the increase in the ratio of α1/ α2 in the collagen fi bers, increased production of osteocalcin, PGE2, MMP and collagenase and decreased response to PTH are signs of abnormal osteoblast activity in OA. These abnormalities may trigger biocemical changes in the cartilage. In order to slow down the increased rate of subchondral bone turnover, administration of antiresorptives, mainly bisphosphanates and calcitonin, is considered in the treatment of OA. Keywords : Osteoarthritis, Bone Remodeling, Subchondral Microfracture