Basic science studies remain a critically important part of the knowledge-discovery process in musculoskeletal patient care. This article highlights several of the key advances in orthopaedic basic science over the past year. It should be noted that some topics of tremendous basic science interest, most notably orthopaedic infection and neoplasia, are not covered in detail in this article because they have been the focus of previous Specialty Update articles in The Journal1,2.
Joints and Joint Disease
A Joint as an Organ
It is now widely accepted that a joint is best considered an organ, rather than a simple tissue, and that osteoarthritis (OA) represents a spectrum of pathologies affecting several of the core structures that make up the joint. Early understanding of OA focused on the changes that were grossly evident on joint inspection, including cartilage degradation, subchondral bone sclerosis, synovial inflammation, and osteophyte formation. More recently, this picture has been expanded to include the contributions of local changes in peri-articular muscles, nerves, and intra-articular structures such as the fat pad. This expanded understanding of the complexity of joint structure and function3 should facilitate the development of more robust and productive in vitro models for studying joint disease and its management. It will also drive the development of more effective regenerative strategies that target multiple aspects of organ function, rather than focusing on cartilage repair/regeneration alone.
The majority of preclinical, induced (i.e., nonnatural) models of OA involve the creation of traumatic instability within the joint. Although this may limit the translational relevance of studies performed with these models, particularly with regard to the efficacy of pharmacological or biological therapies, it has facilitated notable recent advances in our understanding of the effects of trauma on function of the joint organ. Blaker et al. reported on the use of mouse models of posttraumatic OA (PTOA) and …
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