Devor Marshall
Institute of Life Sciences and Center for Research on Pain, The Hebrew University of Jerusalem, Jerusalem, Israel.
Interv Pain Med. 2023 Dec 27;3(1):100381. doi: 10.1016/j.inpm.2023.100381. eCollection 2024 Mar.
Pain in osteoarthritis (OA) results from erosion of joint cartilage, resulting in bone contacting bone without an intervening cushion. The periosteum, including its nociceptive innervation, ends at the border of the cartilage. No other innervated tissue is present between the denuded articular bone ends that could serve as a neuronal pathway to carry a bone-on-bone pain signal to the brain. The pain signaling pathway must therefore originate in afferent axons with electrogenic nociceptive sensory endings that reside within the bone itself, specifically in the opposing surfaces of epiphyseal subchondral bone. Selective ablation of this intrinsic nerve pathway, using any of a variety of approaches, is expected to permanently eliminate OA pain.
骨关节炎（OA）中的疼痛源于关节软骨的侵蚀，导致骨头直接接触而没有中间缓冲。骨膜，包括其伤害性神经支配，在软骨边界处终止。在裸露的关节骨末端之间不存在其他有神经支配的组织，这些组织可以作为将骨对骨疼痛信号传递到大脑的神经通路。因此，疼痛信号通路必须起源于具有电源性伤害性感觉末梢的传入轴突，这些末梢存在于骨本身，特别是在骨骺软骨下骨的相对表面。使用多种方法中的任何一种对这种内在神经通路进行选择性消融，有望永久消除OA疼痛。
