In OA, which of the following occurs during the early stage of subchondral bone pathology?

In OA, which of the following occurs during the early stage of subchondral bone pathology?

• A. Thicker bone plate
• B. Reduced porosity
• C. Increased osteoclastic activity
• D. Decreased turnover

Answer: (C)

In osteoarthritis, subchondral bone remodeling ramps up early on. The initial response to abnormal joint loading is increased activity of osteoclasts that resorb subchondral bone, creating microdamage and allowing a reparative process to kick in. This heightened resorption, part of a surge in bone turnover, fits the early stage of subchondral pathology. Later in OA, the reparative phase can lead to sclerosis and thickening of the subchondral plate, but the very first changes are driven by more osteoclast-driven resorption. So increased osteoclastic activity best explains the early subchondral bone changes.

In osteoarthritis, subchondral bone remodeling ramps up early on. The initial response to abnormal joint loading is increased activity of osteoclasts that resorb subchondral bone, creating microdamage and allowing a reparative process to kick in. This heightened resorption, part of a surge in bone turnover, fits the early stage of subchondral pathology. Later in OA, the reparative phase can lead to sclerosis and thickening of the subchondral plate, but the very first changes are driven by more osteoclast-driven resorption. So increased osteoclastic activity best explains the early subchondral bone changes.