Articular Cartilage, Degenerative Process, and Repair: Current Progress

Abstract

The aim of this paper is to review the current knowledge about degenerative and repair process of articular cartilage, and relationship between osteoarthritis and physical activities. Data Pubmed, ScienceDirect data base are interrogated for the period 1994 - 2003. Key words are: cartilage, osteoarthritis, exercise, rehabilitation. The mechanical biology of the cartilage and the chondrocytes, the effects of physical activity on the cartilage, the main studies on clinical trials on rehabilitation are reviewed. Chondrocyte and cartilage structure and function change with mechanical stresses. Mechanical loads can modulate cartilage matrix turnover. Joint injury increases the risk of osteoarthritis, and sports that subjects joints to repetitive high levels of impact loading increase the risk of injury and degeneration. In human, intensive physical exercises seem associated with osteoarthritis development. None of the current procedures for repairing articular cartilage restores a normal articular zone, however, selected procedures can predictably benefit selected subjects. This article presents the biology and discusses the alteration of cartilage as well as the osteoarthritis process which is not yet well understood. Current medical approaches to the treatment of osteoarthritis also are presented. Rehabilitation programme could be beneficial in the therapeutic management of osteoarthritis.

Key words

Articular cartilage - osteoarthritis - physical activity - mechanical loads

References

• 1 Anderson K, Strickland S M, Warren R. Hip and groin injuries in athletes.  Am J Sports Med. 2001;  29 521-533
• 2 Attur M G, Dave M, Akamatsu M, Katoh M, Amin A R. Osteoarthritis or osteoarthrosis: the definition of inflammation becomes a semantic issue in the genomic era of molecular medicine.  Osteoarthritis Cart. 2002;  10 1-4
• 3 Blyth F M, March L M, Brnabic A JM, Jorm L R, Williamson M, Cousins M J. Chronic pain in Australia: a prevalence study.  Pain. 2001;  89 127-134
• 4 Boyd K T, Peirce N S, Batt M E. Common hip injuries in sport.  Sports Med. 1997;  24 273-288
• 5 Brandt K. Paracetamol in the treatment of osteoarthritis pain.  Drugs. 2003;  63 23-41
• 6 Buckwalter J A, Lane N E. Athletics and osteoarthritis.  Am J Sports Med. 1997;  25 873-881
• 7 Buckwalter J A, Mankin H J. Articular cartilage. Part 2. Degeneration and osteoarthitis, repair, regeneration and transplantation.  J Bone Joint Surg. 1998;  79 A 612-632
• 8 Buckwalter J A, Mankin H J. Articular cartilage: Tissue design and chondrocyte-matrix interactions.  Instr Course. 1998;  47 477
• 9 Buckwalter J A. Articular cartilage: injuries and potential for healing.  J Orthop Sports Phys Ther. 1998;  28 192-202
• 10 Caplan A I, Elyaderani M, Mochizuki Y, Wakitani S, Goldberg V M. Principles of cartilage repair and regeneration.  Clin Orthop Rel Res. 1997;  342 254-272
• 11 Ciobanu A, Ciobanu I R, Halalau F, Laky D, Ionescu T, Dinulescu I, Stanculescu D. Histipathological and ultrastructural modifications of the arthrosis articular cartilage.  Rom J Morph Embryol. 1994;  40 119-123
• 12 Cooper C, Inskip H, Croft P, Campbell L, Smith G, Mac Laren M, Coggon D. Individual risk factors for hip osteoarthritis: obesity, hip injury, and physical activity.  Am J Epidemiol. 1998;  147 516-522
• 13 Cheng Y, Macera C A, Davis D R, Ainsworth B E, Troped P J, Blair S N. Physical activity and self-reported, physician-diagnosed osteoarthritis: is physical activity a risk factor?.  J Clin Epidemiol. 2000;  53 315-322
• 14 Chevalier X. Les médicaments de l’arthrose.  Médecine thérapeutique. 1999;  5 651-653
• 15 Drawer S, Fuller C W. Propensity for osteoarthritis and lower limb joint pain in retired professional soccer players.  Br J Sports Med. 2001;  35 402-408
• 16 Evans C H. Cartilage and synovium. Baratz ME, Watson AD, Imbriglia JE Orthopedic Surgery. The Essentials. New York; Thieme Medical Plublishers Inc 1999: 2033
• 17 Felson D T, Lawrence R C, Dieppe P A, Hirsch R, Helmick C G, Jordan J M, Kington R S, Lane N E, Nevitt M C, Zhang Y, Sowers M, McAlindon T, Spector T D, Poole A R, Yanovski S Z, Ateshian G, Sharma L, Buckwalter J A, Brandt K D, Fries J F. Osteoarthritis: new insights. Part 1: the disease and its risk factors.  Ann Intern Med. 2000;  133 635-646
• 18 Felson D T, Zhang Y. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention.  Arthritis Rheum. 1998;  41 1343-1355
• 19 Fortier L A, Deak M M, Semevolos S A, Cerione R A. Insulin-like growth factor-I diminishes the activation status and expression of the small GTPase Cdc42 in articular chondrocytes.  J Orthop Res. 2004;  22 436-445
• 20 Ghivizzani S C, Oligino T J, Robbins P D, Evans C H. Cartilage injury and repair.  Phys Med Rehabil Clin N Am. 2000;  11 289-307
• 21 Giancotti F G, Ruoslathi E. Integrin signaling.  Science. 1999;  285 1028-1032
• 22 Gouze E, Ghivizzani S C, Robbins P D, Evans C H. Thérapie génique: à portée de doigts.  La Recherche. 2001;  341 40-43
• 23 Gumbiner B M. Cell adhesion: the molecular basis of tissue architecture and morphogenesis.  Cell. 1996;  84 345-357
• 24 Healy W L, Ioro R, Lemos M J. Athletic activity after joint replacement.  Am J Sports Med. 2000;  29 377-388
• 25 Hoffmann L. Réflexions biomécaniques sur la chaussure de handball.  Spe Med Sport. 1996;  2 27-31
• 26 Imhof H, Breitenseher M, Kainberger F, Trattnig S. Degenerative joint disease: cartilage or vascular disease?.  Skel Radiol. 1997;  26 398-403
• 27 Imhof H, Sulzbacher I, Grampp S, Czerny C, Youssefzadeh S, Kainberger F. Subchondral bone and cartilage disease: a rediscovered functional unit.  Invest Radiol. 2000;  35 581-588
• 28 Kerin A, Patwari P, Kuettner K, Cole A, Grodzinsky A. Molecular basis of osteoarthritis: biomechanical aspects.  Cell Mol Life Sci. 2002;  59 27-35
• 29 Knutsson S, Engberg I B. An evaluation of patients' quality of life before, 6 weeks and 6 months after total hip replacement surgery.  J Adv Nurs. 1999;  30 1349-1359
• 30 L'Hermette M, Tourny-Chollet C, Polle G, Leroy D, Dujardin F. Coxarthrosis and mechanical loads in handball playing.  J Hum Mov Studies. 2003;  44 323-338
• 31 Lau E C, Cooper C, Lam D, Chan V NH, Tsang K K, Sham A. Factors associated with osteoarthritis of the hip and knee in Hong Kong chinese: obesity, joint injury, and occupational activities.  Am J Epidemiol. 2000;  152 855-859
• 32 Lee D A, Noguchi T, Frean S P, Lees P, Bader D L. The influence of mechanical loading on isolated chondrocytes seeded in agarose constructs.  Biorheology. 2000;  37 149-161
• 33 Lequesne M, Dang N, Bellan L. Risk factors in a continuous series of 66 hip osteoarthritic (HOA) patients: a prospective study.  Osteoarth Cart. 2001;  9 PA 24
• 34 Loeser R F. Chondrocytic integrin expression and function.  Biorheology. 2000;  37 109-116
• 35 Mandelbaum B R, Browne J E, Fu F, Micheli L, Mosely J B, Erggelet C, Minas T, Peterson L. Articular cartilage lesions of the knee.  Am J Sports Med. 1998;  26 853-861
• 36 Martin J A, Buckwalter J A. Articular cartilage aging and degeneration.  Sports Med Arth Rev. 1996;  4 263-275
• 37 McKinley T O, Rudert M J, Koos D C, Brown T D. Incongruity versus instability in the etiology of posttraumatic arthritis.  Clin Orthop. 2004;  423 44-51
• 38 Naganathan V, Zochling J, March L, Sambrook P N. Peak bone mass is increased in the hip in daughters of women with osteoarthritis.  Bone. 2002;  30 287-292
• 39 Newman A P. Articular cartilage repair.  Am J Sports Med. 1998;  26 309
• 40 Niv D, Gofeld M, Devor M. Causes of pain in degenerative bone and joint disease: a lesson from vertebroplasty.  Pain. 2003;  105 387-392
• 41 Oliveria S A, Felson D T, Cirillo P A, Reed J I, Walker A M. Body weight, body mass index, and incident symptomatic osteoarthritis of the hand, hip and knee.  Epidemiology. 1999;  10 161-166
• 42 Pozzi A, Wary K K, Giancotti F G, Gardner H A. Integrin alpha1beta1 mediates a unique collagen-dependent proliferation pathway in vivo.  J Cell Biol. 1998;  142 587-594
• 43 Scudds R J, Ostbye T. Pain and pain-related interference with function in older Canadians: the Canadian study of health and aging.  Disabil Rehabil. 2001;  23 654-664
• 44 Setton L A, Elliott D M, Mow V C. Altered mechanics of cartilage with osteoarthritis: human osteoarthritis and an experimental model of joint degeneration.  Osteoarthritis Cart. 1999;  7 2-14
• 45 Setton L A, Mow V C, Homell D S. Changes in the shear properties of canine knee cartilage resulting from anterior cruciate transection.  J Orthop Res. 1995;  13 473-482
• 46 Trippel S B, Ghivizzani S C, Nixon A J. Gene-based approaches for the repair of articular cartilage.  Gene Ther. 2004;  11 351-359
• 47 Urban J PG. Present perspectives on cartilage chondrocyte mechanobiology.  Biorheology. 2000;  37 185-190
• 48 van Baar M E, Assendelft W J, Dekker J, Oostendorp R A, Bijlsma J W. Effectiveness of exercise therapy in patients with osteoarthritis of the hip and knee.  Arthritis Rheum. 1999;  42 1361-1369
• 49 van den Berg W. Pathophysiology of osteoarthritis.  Joint Bone Spine. 2000;  67 555-556
• 50 Vingård E, Alfredsson L, Goldie I, Hogstedt C. Sports and osteoarthrosis of the hip.  Am J Sports Med;. 1993;  21 195-200
• 51 Vingård E, Alfredsson L, Goldie I, Hogstedt C. Occupation and osteoarthrosis of the hip and knee: A register-based cohort study.  Int J Epidemiol. 1991;  20 1025-1031
• 52 Vingård E, Alfredsson L, Malchau H. Osteoarthrosis of the hip in women and its relationship to physical load from sports activities.  Am J Sports Med. 1998;  26 78-82
• 53 von Eisenhart R V, Adam C, Steinlechner M, Muller-Gerbl M, Eckstein F. Quantitative determination of joint incongruity and pressure distribution during simulated gait and cartilage thickness in the human hip joint.  J Orthop Res. 1999;  17 532-539
• 54 von Eisenhart-Rothe R V, Witte H, Steinlechner M, Müller-Gerbl M, Putz R, Eckstein F. Quantitative determination of joint incongruity and contact pressure in the human hip joint during the gait-cycle.  Unfallchirurg. 1999;  102 625-631
• 55 Xia Y. The total volume and the complete thickness of articular cartilage determined by MRI.  Osteoarth Cart. 2003;  11 473-474