Problems with Articular Cartilage

Question 1

Osteoarthritis:
What are the inflammatory changes that occur?

What factors impact the activation of degrading enzymes? How does this relate to OA?

Describe the Early and Late stages of cartilage breakdown

Answer 1

• Lining cell hyperplasia, Increased Vascularity, Invasion of inflammatory cells (Macrophages), Fibrosis
• Injury, Aging, Mechanical stress, Degraded ECM, Inflammatory Cytokines, Genetics, Obesity; in OA, the process of inhibiting these enzymes is uncontrolled
• • Early stages; Early fibrillation and Chondrocyte loss - Aggrecanase activity

• Late stages - Deep fissuring, Chondrocyte death, Matrix loss - MMP activity (cleaves Type 2 Collagen and is irreversible)

Question 2

How is OA treated?

Answer 2

• Opiates, Cannabinoids, Corticosteroids, Aspiration, Hyaluronic acid, Growth factors, Gene therapy

• Joint distraction (opening up joint space to offload the joint and encourage cartilage growth)
o To control pain - Steroid injections, Capsaicin, NSAIDS

• Autologous Chondrocyte Implantation for Chondral Defects