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Bio-orthopaedics pp 503–515Cite as

Clinical Orthobiological Approach to Acute Cartilage Injury: Pros and Cons

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Abstract

Articular cartilage has the ability to absorb stress, create low friction and high resistance to wear, which provide smooth joint movement and weight-bearing capabilities. To enable these special properties, cartilage has a peculiar structure. Articular cartilage is composed of a small number of chondrocytes and extracellular matrix (ECM). Chondrocytes constitute approximately 1% of the cartilage tissue and play a role in maintaining a healthy ECM. The ECM consists of a network of collagen fibrils with proteoglycan. Type 2 collagen is the main component, with Type 9 and 11 constituting minor components. The structure of the articular cartilage is divided into four zones: the superficial, transition, deep, and calcified zone. Each zone has a different cell size, shape, number, and content, comprising different properties of ECM. The tidemark anchors cartilage tissue to the subchondral bone plate. Notably, cartilage has neither vascularity nor nerves, which make spontaneous repair difficult [1]. Thus, untreated cartilage defects, especially those greater than 1.5 cm in diameter, will eventually progress to osteoarthritis (OA). To prevent the progression of OA after cartilage injury, the diagnosis and choice of appropriate treatment in the acute phase of OA is crucial to the achievement of biological healing.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Tomoyuki Nakasa, Nobuo Adachi & Mitsuo Ochi

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  1. Tomoyuki Nakasa
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  2. Nobuo Adachi
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  3. Mitsuo Ochi
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Correspondence to Tomoyuki Nakasa .

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Editors and Affiliations

  1. O.A.S.I. Bioresearch Foundation NPO, Milan, Italy

    Alberto Gobbi

  2. Clínica do Dragão, Espregueira-Mendes Sports Centre – FIFA Medical Centre of Excellence, Porto, Portugal

    João Espregueira-Mendes

  3. Musculoskeletal and Joint Research Foundation, San Diego, California, USA

    John G. Lane

  4. Department of Orthopedics, Acibadem University, Istanbul, Turkey

    Mustafa Karahan

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Nakasa, T., Adachi, N., Ochi, M. (2017). Clinical Orthobiological Approach to Acute Cartilage Injury: Pros and Cons. In: Gobbi, A., Espregueira-Mendes, J., Lane, J., Karahan, M. (eds) Bio-orthopaedics. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54181-4_40

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