Osteoarthritis (OA) is a common chronic, progressive joint disease that mainly affects weight-bearing joints such as the hip and knee. The affected joints undergo a complex process of tissue breakdown and repair, resulting in changes in joint structure such as articular cartilage and subchondral bone, which severely affects joint function [1]. The knee is the most commonly affected joint, and the disease may require joint replacement at advanced stages, resulting in costly treatment that imposes a heavy financial burden on patients.The treatment of OA initially focuses on symptom relief, but such drugs do not stop the progression of the disease and the destruction of joint structures. As the disease is better understood, there is increasing evidence that cartilage and subchondral bone play an important role in OA disease development and progression [2]. Therefore, the use of drugs that act by affecting bone metabolism in OA has also received increasing attention. Risedronate has been shown to inhibit bone resorption by affecting osteoclasts, increase bone mineral density, and slow disease progression in a porcine OA model [3]. To clarify the efficacy and safety of risedronate in patients with knee OA, a 1-year prospective, double-blind, placebo-controlled BRISK study was conducted at St Thomas’ Hospital, UK, to explore the efficacy of risedronate on symptoms and joint structure in patients with knee OA [4]. A total of 284 patients aged 40-80 years with mild to moderate knee OA were enrolled in the study and randomized to three groups: the risedronate 5 mg/d group, the risedronate 15 mg/d group and the placebo control group. Radiological imaging information of the knee was collected at baseline and at the end of the study, and joint space width was assessed by fluoroscopic localization; pain, function and stiffness were assessed using the WOMAC OA index, as well as overall patient condition and use of walking aids and levels of bone and articular cartilage markers (CTX-II, NTX-Ⅰ). The results showed that patients in the 15 mg/d risedronate group showed improvement in WOMAC index compared with the placebo group, with particularly significant improvement in somatic function; significant improvement in overall patient assessment (p<0.001< span="">) and a greater decrease in the proportion using walking aids (p=0.009); and a slower trend in joint space narrowing. Detectable disease progression (≥25% reduction in joint space width or ≥0.75 mm) was seen in 8% (n=7) and 4% (n=4) of patients in the placebo and 5 mg/d risedronate groups, respectively, compared with 1% (n=1) in the 15 mg/d risedronate group. levels of cartilage degradation and bone resorption markers were significantly reduced in patients in the 15 mg/d risedronate group. Both doses of risedronate were well tolerated. Thus, risedronate may affect bone metabolism by reducing the levels of bone turnover markers, increase the density of subchondral bone trabeculae, significantly relieve symptoms, slow down or even reverse the destruction of OA joint structures, and play a positive role in bone and cartilage protection, which may become a powerful weapon in OA treatment. (Lv Liangjing Personal Weixin Platform:luliangjing920) References 1. Dixon, T., et al. Trends in hip and knee joint replacement: socioeconomic inequalities and projections of need. Ann Rheum Dis, 2004. 63(7): p. 825-30.2. Spector, T.D., Bisphosphonates: potential therapeutic agents for disease modification in osteoarthritis. Aging Clin Exp Res, 2003. 15(5): p. 413-8.3. J.M., M., et al., Bisphosphonates structurally similar to risedronate (actonel) slow disease progression in the guinea pig model of primary osteoarthritis [abstract]. Arthritis Rheum, 2001. 5307: p. 1527.4. Spector, T.D., et al., Effect of risedronate on joint structure and symptoms of knee osteoarthritis: results of the BRISK randomized, controlled trial [ISRCTN01928173]. Arthritis Res Ther, 2005. 7(3): p. R625-33.