Emerging insights into cellular senescence highlight the relevance of senescence in musculoskeletal disorders, which represent the leading global cause of disability. Cellular senescence was initially described by Hayflick et al. in 1961 as an irreversible nondividing state in in vitro cell culture studies. We now know that cellular senescence can occur in vivo in response to various stressors as a heterogeneous and tissue-specific cell state with a secretome phenotype acquired after the initial growth arrest. In the past two decades, compelling evidence from preclinical models and human data show an accumulation of senescent cells in many components of the musculoskeletal system. Cellular senescence is therefore a defining feature of age-related musculoskeletal disorders, and targeted elimination of these cells has emerged recently as a promising therapeutic approach to ameliorate tissue damage and promote repair and regeneration of the skeleton and skeletal muscles. In this review, we summarize evidence of the role of senescent cells in the maintenance of bone homeostasis during childhood and their contribution to the pathogenesis of chronic musculoskeletal disorders, including osteoporosis, osteoarthritis, and sarcopenia. We highlight the diversity of the senescent cells in the microenvironment of bone, joint, and skeletal muscle tissue, as well as the mechanisms by which these senescent cells are involved in musculoskeletal diseases. In addition, we discuss how identifying and targeting senescent cells might positively affect pathologic progression and musculoskeletal system regeneration.

对细胞衰老的新见解强调了衰老与肌肉骨骼疾病的相关性，肌肉骨骼疾病是导致全球残疾的主要原因。细胞衰老最初由 Hayflick 等人描述。1961 年在体外细胞培养研究中作为不可逆转的非分裂状态。我们现在知道，细胞衰老可以在体内发生，以响应各种压力因素，作为异质和组织特异性细胞状态，在初始生长停滞后获得分泌组表型。在过去的二十年中，来自临床前模型和人类数据的令人信服的证据表明，肌肉骨骼系统的许多组件中都存在衰老细胞的积累。因此，细胞衰老是与年龄相关的肌肉骨骼疾病的一个决定性特征，最近，有针对性地消除这些细胞已成为改善组织损伤和促进骨骼和骨骼肌修复和再生的一种有前途的治疗方法。在这篇综述中，我们总结了衰老细胞在维持儿童时期骨稳态中的作用及其对慢性肌肉骨骼疾病（包括骨质疏松症、骨关节炎和肌肉减少症）发病机制的贡献的证据。我们强调了骨骼、关节和骨骼肌组织微环境中衰老细胞的多样性，以及这些衰老细胞参与肌肉骨骼疾病的机制。此外，我们讨论了识别和靶向衰老细胞如何对病理进展和肌肉骨骼系统再生产生积极影响。