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Cartilage (Treatment options (Limitations (Chondrocyte mobility (Bound in…

- - - - Bound in lacunae
      - Cannor migrate to damaged area
    - - Replacement by fibrocartilage
  - - - Low efficacy
  - - - Highly invasive
      - Pain relief and improved
        range of motion
      - Rehab is critical
      - High failure rate over time
        
        Used for older patients
        
        Complicated revision surgery
    - - Biopsy (6 weeks prior)
        
        remove healthy cartilage
        from non-load bearing area
        
        Expand cell number in vitro
        
        Harvest periosteum from health bone
        
        Debride
        
        Sharp edges
        
        Suture periosteum over defect
        
        Inject saline to test seal
        
        Fibrin glue to fix leaks
        
        Aspirate saline
        
        Inject cell suspension under sheet
      - Can produce cartilage-like tissue
      - Fills defect of any size
      - 2 invasive surgeries
      - Long recovery
      - Expensice
    - - Performed arthoscopically
      - Healthy cartilage+
        subchondral bone removed
        
        Transplanted to damage site
        
        Integration problems
        
        Donor site morbidity
      - Small defects only
      - Long term prognosis unknown
    - - Can repair larger defects
      - Chondrocytes may not be viable
      - Hyaline cartilage with correct phenotype and function
      - May not integrate with surrounding error
      - Disease transmission
      - Limited supply
    - - Simple, single, arthoscopic surgery
      - Bone marrow forms blood clot
        
        Defect invaded by progenitor cells
        
        Fibrocartilage formed
      - Bad long-term prognosis
      - Removal of damaged, brittle cartilage
  - - - Collagen directionality
      - Density
- - - - Very limited blood supply
    - - Higher stiffness in tension
        than compression
    - - Age
      - Type
      - Joint
      - Location and depth
      - Biochemical composition
        
        Water content
        
        Proteoglycan content
        
        Collagen and elastin content
        
        Collagen content has no effect
        on compressive modulus
  - - - No deformation
  - - - Bound in Lacunae
      - Produce and maintain ECM
    - - Collagen
        
        alpha protein chains
        
        Procollagen
        
        Triple helix
        
        Collagen fibril
        
        Collagen fiibre
        
        Overlap of helices
        
        Stabilised by H bonds
        
        Formed outside the cell
        
        loose ends
        
        Formed in cell ER
      - Elastin
        
        Proteins
        
        Covalent crosslinks between lysines
        
        Can stretch, but
        structure is maintained
        
        Lost with age -> creep
        
        Ligaments, lung tissue
      - Ground substance
        
        Glycoproteins
        
        GAGs
        
        Linear, repeating dissacharides
        
        May be sulfated
        
        Negatively charged
        
        Bind cations & growth factors
        
        Hydrophillic
        
        Repel each other
        
        Hydrated matrix
        
        Resists compression
        
        Absorb H2O
        
        Bind to elastins and collagens
        
        Proteoglycans
        
        Core protein
        
        GAGs
        
        Absorbs a lot of H2O
      - High water content
    - - Low metabolic rate
- - - - Load-bearing surfaces of synovial joints
      - Nose
      - Ribcage
    - - Lubrication
        
        Lubricin
      - Resistance to compressive forces
        
        Proteoglycans generate high
        osmotic swelling pressure
        
        A rest tissue fills with water
        
        Contained by the collagen meshwork
        
        Under load
        
        Cartilage is compressed
        
        Water is removed until
        swelling pressure =
        compressive force
        
        Force removed
        
        1 more item...
    - - 1-5% chondrocytes
      - 65-80% water
      - 10-20% collagen 2
      - 4-7% proteoglycans
    - - Superficial/Tangential
        
        Highest collagen content
        
        Collagen fibres orientate parallel to
        the joint surface to resist shear.
      - Middle
        
        Lowest collagen content
        
        Disordered organisation
        
        Site of collagen production
      - Deep
        
        Collagen fibres orientated
        perpendicularly to the surface
  - - - External ear
      - Tubular structures
        
        Auditory tubes
        
        Epiglottis
    - - Similar to Hyaline
      - Elastin fibres
        
        Orientated in all directions
      - Surrounded by the perichondrium
    - - Provides strength & support
      - Maintains shape of organs
    - - Stiff
      - Elastic
  - - - Intevertabral discs
      - Pubic symphysis
      - Menisci
    - - Similar to Hyaline
      - More collagen
      - Less proteoglycans
      - Chondrocytes form short rows
        between dense collagen fibres
    - - Tough
      - High tensile strength
      - Little shock absorption
      - Little lubrication
    - - Links dense connective tissue and hyaline cartilage
      - Provides resistance to regular stress
- - - - Degenerated cartilage
        
        Osteoarthritis
        
        Pain
        
        Compromises joint surfaces
        
        Loss of motion
        
        cooked crab meat
      - Soft and spongy
  - - - Release of proteases
        
        Degradation of
        proteoglycans
        
        Reduces ability of joint
        to withstand high stresses
        
        Further fibrilisation and damage
        
        Synovitis
      - Meniscal tear
        
        Location of tear affects severity