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. 2020 Apr 8;79(6):811–818. doi: 10.1136/annrheumdis-2020-216942

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© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Representative images of horizontal fissures in the osteochondral units from OA patients with normal weight and morbid obesity. In patients with normal weight (A), cartilage is firmly attached on calcified cartilage (CC). In patients with obese class III (B), a horizontal fissure is observed at the osteochondral interface between the articular cartilage (AC) and subchondral bone (SCB). Free bone debris (black arrowhead) and cartilage erosion (empty arrow) are presented within the fissure.