Constraints to Articular Cartilage Regeneration

Abstract

The glassy translucent material found at the ends of bones, within synovial joints, is termed articular cartilage. While healthy, it provides a low-friction bearing surface, preventing bone-to-bone contact, and to an extent, absorb shock during vigorous activities. However, when damaged could lead to pain, deformity and reduced mobility; the social impact of which, entails high costs in terms of therapeutic treatments and loss of income. The present chapter reviews the common knowledge of the constraints to articular cartilage regeneration; namely cartilage structure, composition and major diseases. The first of the three sections detail the major constituents of the tissue and their structural organisation; the tissues mechanical properties, and ends with a brief description of how these features change in an unhealthy cartilage; be it mechanical or disease. In the second section, both clinical and academic approaches are pooled together, to review the current strategies in restoring health to joints with diseased or damaged cartilage. The final section highlights the fact that progression of cartilage disease affects not only the cartilage, but its underlying bone. The implications of the subchondral bone in the propagation of cartilage degeneration are discussed, and finally, their considerations in cartilage defect healing.