Subchondral bone is involved in the development of osteoarthritis, with an excess in bone resorption at an early stage and increased bone formation thereafter. Experimental and observational studies suggest that acting on bone can change progression of osteoarthritis. Clinical prospective controlled studies failed to confirm this result. Appropriate identification of patients at high risk of developing cartilage deterioration is a key issue for the analysis of impact of treatments for osteoporosis on osteoarthritis progression.