Micro-computed tomographical and histopathological analyses of medial tibial plateaus from patients with subchondral insufficiency fracture or osteoarthritis of the knee
Authors' conclusion
Our data demonstrate that T-SIFK is generated by subchondral bone fracture and its repair reaction and suggest that fat necrosis of the bone marrow is involved in BML formation in T-SIFK and OA.
Study context
- Population
- Patients with femoral or tibial subchondral insufficiency fracture of the knee (SIFK) or knee osteoarthritis (OA), diagnosed by radiography and magnetic resonance imaging (MRI), undergoing unicompartmental knee arthroplasty19 SIFK, 24 OA
- Participants
- 9 / 10 / 24
- Comparison
- Tibial SIFK vs knee OA
- T-SIFKn = 9
- F-SIFKn = 10
- OAn = 24reference
Methodological detailsMicro-computed tomography (micro-CT) and histopathological analysis, biomarker analysis
- micro-CT and histopathological analysis
- Biomarker analysis
Main finding
As reported in the abstract
- T-SIFK lesion comprises multiple subchondral bone fragments covered with articular cartilage (micro-CT)
- Histologically, lesion of cartilage-covered subchondral bone fragments, debris of bone and bone marrow, fibrogranulation tissue, cartilage and woven bone
- All T-SIFK patients showed bone marrow lesions (BMLs) with a subchondral hypointense line on MRI
- OA medial tibial plateaus frequently showed eburnation, commonly with microfracture
- All BMLs in T-SIFK and OA associated with fat necrosis (disrupted fat cells, foamy macrophage infiltration)
Further findings
| Outcome | T-SIFK | OA |
|---|---|---|
| Posterior tibial slope angleSignificantly higher in T-SIFK than OA | 12.84 ± 2.34 ° | 9.58 ± 2.84 ° |
| Medial meniscal posterior root tearsSignificantly higher in T-SIFK than OA | 68.4% | 25.0% |
| Grade 2 subchondral bone resorption pits, uninvolved areas of medial tibial plateausSignificantly higher in T-SIFK than OA | 2.32 ± 1.43 | 0.72 ± 0.66 |
| Grade 2 subchondral bone resorption pits, femoral condylesSignificantly higher in T-SIFK than OA | 5.53 ± 3.73 | 1.50 ± 2.10 |
Original publication
Micro-computed tomographical and histopathological analyses of medial tibial plateaus from patients with subchondral insufficiency fracture or osteoarthritis of the knee. Arthritis Res Ther. Published 16 January 2026. doi:10.
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