the end of a long bone covered in articular hyaline cartilage
epiphysis
3383950
Long bone The long bones are those that are longer than they are wide. They are one of five types of bones: long, short, flat, irregular and sesamoid. Long bones, especially the femur and tibia, are subjected to most of the load during daily activities and they are crucial for skeletal mobility. They grow primarily by elongation of the diaphysis, with an epiphysis at each end of the growing bone. The ends of epiphyses are covered with hyaline cartilage ("articular cartilage"). The longitudinal growth of long bones is a result of endochondral ossification at the epiphyseal plate. Bone growth in
Long bone
3383950
Long bone The long bones are those that are longer than they are wide. They are one of five types of bones: long, short, flat, irregular and sesamoid. Long bones, especially the femur and tibia, are subjected to most of the load during daily activities and they are crucial for skeletal mobility. They grow primarily by elongation of the diaphysis, with an epiphysis at each end of the growing bone. The ends of epiphyses are covered with hyaline cartilage ("articular cartilage"). The longitudinal growth of long bones is a result of endochondral ossification at the epiphyseal plate. Bone growth in
Long bone
2489550
Epiphysis The epiphysis is the rounded end of a long bone, at its joint with adjacent bone(s). Between the epiphysis and diaphysis (the long midsection of the long bone) lies the metaphysis, including the epiphyseal plate (growth plate). At the joint, the epiphysis is covered with articular cartilage; below that covering is a zone similar to the epiphyseal plate, known as bone. The epiphysis is filled with red bone marrow, which produces erythrocytes (red blood cells). There are four types of epiphysis: There are many bones that contain an epiphysis: A "pseudo-epiphysis" is an epiphysis-looking end of a bone where
Epiphysis
4480285
long bones and other bones. This requires a hyaline cartilage precursor. There are two centers of ossification for endochondral ossification. The primary center In long bones, bone tissue first appears in the diaphysis (middle of shaft). Chondrocytes multiply and form trebeculae. Cartilage is progressively eroded and replaced by hardened bone, extending towards the epiphysis. A perichondrium layer surrounding the cartilage forms the periosteum, which generates osteogenic cells that then go on to make a collar that encircles the outside of the bone and remodels the medullary cavity on the inside. The nutrient artery enters via the nutrient foramen from a
Ossification
7411302
hyaline articular cartilage is progressively mineralized at the junction between cartilage and bone. It is then termed "articular calcified cartilage". A mineralization front advances through the base of the hyaline articular cartilage at a rate dependent on cartilage load and shear stress. Intermittent variations in the rate of advance and mineral deposition density of the mineralizing front, lead to multiple "tidemarks" in the articular calcified cartilage. Adult articular calcified cartilage is penetrated by vascular buds, and new bone produced in the vascular space in a process similar to endochondral ossification at the physis. A "cement line" demarcates articular calcified cartilage
Chondrogenesis
16712611
and that its formation yielded only short term clinical benefits, Stone proposed his paste grafting as a means of regenerating hyaline-like cartilage. The hypothesis was that harvesting a mixture of articular cartilage and cancellous bone would combine pluripotent cells of the cancellous bone with cartilage extracellular matrix and growth factors and when exposed to continuous motion, hyaline-like cartilage would be stimulated to form. Published descriptions of the articular cartilage stem cell paste grafting technique are readily available. The procedure is performed in an outpatient setting under general anesthesia. The surgical steps are summarized here: Postoperatively, patients are requested to use
Articular cartilage stem cell paste grafting
9313445
Shoulder arthritis Shoulder arthritis can be one of three types of arthritis in the glenohumeral joint of the shoulder. The glenohumeral joint is a ball and socket joint, which relies on cartilage to move smoothly and to operate normally. Shoulder arthritis is a clinical condition in which the joint that connects the ball of the arm bone (humeral head) to the shoulder blade socket (glenoid) has damaged or worn out cartilage. Normally the ends of the bone are covered with hyaline articular cartilage, a surface so smooth that the friction at the joint is less than that of an ice
Shoulder arthritis
12397029
fill in articular cartilage defects, its structure is significantly different from that of hyaline cartilage; it is much denser and it doesn't withstand the demands of everyday activities as much as hyaline cartilage. It is therefore at a higher risk of breaking down. Wang "et al."(2006) found that small articular cartilage defects can progress to osteoarthritis over time if left untreated. An articular cartilage defect that initially may be small still has the potential to have a physical and chemical "domino effect" on the surrounding "normal" articular cartilage. Though articular cartilage damage is not life-threatening, it does strongly affect one's
Articular cartilage damage
4020643
the joint cavity of synovial joints, bathed in synovial fluid produced by the synovial membrane, which lines the walls of the cavity. Though it is often found in close contact with menisci and articular disks, articular cartilage is not considered a part of either of these structures, which are made entirely of fibrocartilage. The biochemical breakdown of the articular cartilage results in osteoarthritis - the most common type of joint disease. Osteoarthritis affects over 30 million individuals in the United States alone, and is the leading cause of chronic disability amongst the elderly. Hyaline cartilage Hyaline cartilage is the glass-like
Hyaline cartilage
17869787
calcium from the alginate gel, these cells become bone cells and start producing bone matrix through the intra-membranous ossification process, recapitulating all steps of bone matrix deposition. The extension of the IVB paradigm to engineering autologous hyaline cartilage was also recently demonstrated. In this case, agarose is injected and this triggers local hypoxia, which then results in the differentiation of the periosteal MSCs into articular chondrocytes, i.e. cells similar to those found in the joint cartilage. Since this processes occurs in a relative short period of less than two weeks and cartilage can remodel into bone, this approach might provide
In vivo bioreactor
7227661
jaw. In early fish and in chondrichthyans (cartilaginous fish such as sharks), the Meckelian Cartilage continued to be the main component of the lower jaw. But in the adult forms of osteichthyans (bony fish) and their descendants (amphibians, reptiles, birds, mammals), the cartilage was covered in bone – although in their embryos the jaw initially develops as the Meckelian Cartilage. In all tetrapods the cartilage partially ossifies (changes to bone) at the rear end of the jaw and becomes the articular bone, which forms part of the jaw joint in all tetrapods except mammals. In some extinct mammal groups like
Meckel's cartilage
12388688
Articular cartilage repair The aim of an articular cartilage repair treatment is to restore the surface of an articular joint's hyaline cartilage. Over the last decades, surgeons and researchers have been working hard to elaborate surgical cartilage repair interventions. Though these solutions do not perfectly "restore" articular cartilage, some of the latest technologies start to bring very promising results in "repairing" cartilage from traumatic injuries or chondropathies. These treatments are especially targeted by patients who suffer from articular cartilage damage. They provide pain relief while at the same time slowing down the progression of damage or considerably delaying joint replacement
Articular cartilage repair
6942865
list of suggested treatments. A variety of surgical options exist for the treatment of persistently symptomatic, intact, partially detached, and completely detached OCD lesions. Post-surgery reparative cartilage is inferior to healthy hyaline cartilage in glycosaminoglycan concentration, histological, and immunohistochemical appearance. As a result, surgery is often avoided if non-operative treatment is viable. If non-surgical measures are unsuccessful, drilling may be considered to stimulate healing of the subchondral bone. Arthroscopic drilling may be performed by using an antegrade (from the front) approach from the joint space through the articular cartilage, or by using a retrograde (from behind) approach through the bone
Osteochondritis dissecans
6374878
In ichthyology and entomology, "hyaline" denotes a colorless, transparent substance, such as unpigmented fins of fishes or clear insect wings. Hyaline A hyaline substance is one with a glassy appearance. The word is derived from "transparent" and "crystal, glass". In histopathological medical usage, a hyaline substance appears glassy and pink after being stained with haematoxylin and eosin—usually it is an acellular, proteinaceous material. An example is hyaline cartilage, a transparent, glossy articular joint cartilage. Some mistakenly refer to all hyaline as hyaline cartilage; however, hyaline applies to other material besides the cartilage itself. Arterial hyaline is seen in aging, high
Hyaline
12388701
between femur and tibia bones. Similarly, a 2013 Finnish study found surgery to be ineffective for knee surgery (arthroscopic partial meniscectomy), by comparing to sham treatment. Articular cartilage repair The aim of an articular cartilage repair treatment is to restore the surface of an articular joint's hyaline cartilage. Over the last decades, surgeons and researchers have been working hard to elaborate surgical cartilage repair interventions. Though these solutions do not perfectly "restore" articular cartilage, some of the latest technologies start to bring very promising results in "repairing" cartilage from traumatic injuries or chondropathies. These treatments are especially targeted by patients
Articular cartilage repair
6374877
Hyaline A hyaline substance is one with a glassy appearance. The word is derived from "transparent" and "crystal, glass". In histopathological medical usage, a hyaline substance appears glassy and pink after being stained with haematoxylin and eosin—usually it is an acellular, proteinaceous material. An example is hyaline cartilage, a transparent, glossy articular joint cartilage. Some mistakenly refer to all hyaline as hyaline cartilage; however, hyaline applies to other material besides the cartilage itself. Arterial hyaline is seen in aging, high blood pressure, diabetes mellitus and in association with some drugs (e.g. calcineurin inhibitors). It is bright pink with PAS staining.
Hyaline
12388696
to maintain a higher activity level that traditional joint replacements would not allow. Advances in tissue preservation and surgical technique are quickly growing this surgery in popularity. Aiming to obtain the best possible results, scientists have striven to replace damaged articular cartilage with healthy articular cartilage. Previous repair procedures, however, always generated fibrocartilage or, at best, a combination of hyaline and fibrocartilage repair tissue. Autologous chondrocyte implantation (ACI) procedures are cell-based repairs that aim to achieve a repair consisting of healthy articular cartilage. ACI articular cartilage repair procedures take place in three stages. First, cartilage cells are extracted arthroscopically from
Articular cartilage repair
20693708
synthetic cartilage to be used in joint spaces, high mechanical strength under compression needs to be an intrinsic property of the material. There are three types of cartilage in the human body: fibrocartilage, hyaline cartilage and elastic cartilage. Each type of cartilage has varying concentrations of components such as proteoglycans, collagen and water which determine its functional properties and location in the body. Fibrocartilage is most often found in the intervertebral discs, elastic cartilage is found in the external ear and hyaline cartilage is found on many joint surfaces in the body. Replacement of hyaline cartilage (articular cartilage) is the
Artificial cartilage
16712610
therefore its cells are dependent upon diffusion for the supply of oxygen and nutrients. Its intrinsic healing capacity is low. Injury to cartilage can lead to pain and stiffness and is the precursor to the development of osteoarthritis (degenerative joint arthritis). Articular cartilage stem cell paste grafting was initially described by Kevin R. Stone M.D., a San Francisco-based orthopedic surgeon, in 1997 . The technique was devised in response to reports that many of the contemporary cartilage restoration procedures lead to the development of fibrocartilage, not true hyaline articular cartilage. Knowing that fibrocartilage was not as durable as articular cartilage
Articular cartilage stem cell paste grafting
18623211
of range of motion associated with joint capsule fibrosis. Treatment of joint cartilage injury is difficult and often unrewarding. Partial-thickness defects do not heal. The body will try to repair full-thickness cartilage defects using scar tissue or fibrocartilage, both of which are poor substitutes for normal, healthy articular cartilage. Current treatment includes arthroscopy-produced microfratures within the subchondral plate. These microfractures encourage an inflammatory response within the defect, which recruits stem cells to the area. Unfortunately, these cells differentiate into fibrocartilage, rather than normal joint (hyaline) cartilage, leading to inferior tissue repair at the site of injury. Bone marrow aspirate concentrate
Treatment of equine lameness
9483306
tissue consisting of fibrous tissue, fibrocartilage or hyaline-like cartilage. The quality of the repair tissue after these "bone marrow stimulating techniques" depends on various factors including the species and age of the individual, the size and localization of the articular cartilage defect, the surgical technique, e.g., how the subchondral bone plate is treated, and the postoperative rehabilitation protocol. The surgery was developed in the late 1980s and early 1990s by Dr. Richard Steadman of the Steadman-Hawkins clinic in Vail, Colorado. Steadman slowly refined the procedure through research (including tests on horses). The surgery was soon called "controversial" by many sportswriters,
Microfracture surgery
4020642
cavities in the matrix, called cartilage lacunæ. These cavities are actually artificial gaps formed from the shrinking of the cells during the staining and setting of the tissue for examination. The inter-territorial space between the isogenous cell groups contains relatively more collagen fibres, allowing it to maintain its shape while the actual cells shrink, creating the lacunae. This constitutes the so-called 'capsule' of the space. Each lacuna is usually occupied by a single cell, but during mitosis, it may contain two, four, or even eight cells. Articular cartilage is hyaline cartilage on the articular surfaces of bones, and lies inside
Hyaline cartilage
12388690
pain, mechanical restriction and inflammation. Lavage focusses on removing degenerative articular cartilage flaps and fibrous tissue. The main target group are patients with very small defects of the articular cartilage. Marrow stimulating techniques attempt to solve articular cartilage damage through an arthroscopic procedure. Firstly, damaged cartilage is drilled or punched until the underlying bone is exposed. By doing this, the subchondral bone is perforated to generate a blood clot within the defect. Studies, however, have shown that marrow stimulation techniques often have insufficiently filled the chondral defect and the repair material is often fibrocartilage (which is not as good mechanically
Articular cartilage repair
1801476
the granulation tissue develop into chondroblasts which also form hyaline cartilage. These two new tissues grow in size until they unite with each other. These processes culminate in a new mass of heterogeneous tissue known as a fracture callus. Callus formation peaks at day 14 of fracture. Eventually, the fracture gap is bridged. The next phase is the replacement of the hyaline cartilage and woven bone with lamellar bone. The replacement process is known as endochondral ossification with respect to the hyaline cartilage and bony substitution with respect to the woven bone. Substitution of woven bone happens before substitution of
Bone healing
2171066
extent resemble tendon cells. The collagenous fibers are usually placed in an orderly arrangement parallel to tension on the tissue. It has a low content of glycosaminoglycans (2% of dry weight). Glycosaminoglycans are long, unbranched polysaccharides (relatively complex carbohydrates) consisting of repeating disaccharide units. Fibrocartilage does not have a surrounding perichondrium. Perichondrium surrounds the cartilage of developing bone; it has a layer of dense, irregular connective tissue and functions in the growth and repair of cartilage. Hyaline cartilage is the white, shiny gristle at the end of long bones. This cartilage has poor healing potential, and efforts to induce it
Pubic symphysis
8312599
ends and thus demonstrated the existence of the epiphyseal plates. Hunter is considered the "father of the growth plate." Epiphyseal plate The epiphyseal plate (or epiphysial plate, physis, or growth plate) is a hyaline cartilage plate in the metaphysis at each end of a long bone. It is the part of a long bone where new bone growth takes place; that is, the whole bone is alive, with maintenance remodeling throughout its existing bone tissue, but the growth plate is the place where the long bone grows longer (adds length). The plate is not only found in children and adolescents;
Epiphyseal plate
8312595
Epiphyseal plate The epiphyseal plate (or epiphysial plate, physis, or growth plate) is a hyaline cartilage plate in the metaphysis at each end of a long bone. It is the part of a long bone where new bone growth takes place; that is, the whole bone is alive, with maintenance remodeling throughout its existing bone tissue, but the growth plate is the place where the long bone grows longer (adds length). The plate is not only found in children and adolescents; in adults, who have stopped growing, the plate is replaced by an epiphyseal line. This replacement is known as
Epiphyseal plate
12400140
Autologous chondrocyte implantation Autologous chondrocyte implantation (ACI, ATC code ) is a biomedical treatment that repairs damages in articular cartilage. ACI provides pain relief while at the same time slowing down the progression or considerably delaying partial or total joint replacement (knee replacement) surgery. The goal of ACI is to allow people suffering from articular cartilage damage to return to their old lifestyle; regaining mobility, going back to work and even practicing sports again. ACI procedures aim to provide complete hyaline repair tissues for articular cartilage repair. Over the last 20 years, the procedure has become more widespread and it
Autologous chondrocyte implantation
12406597
animal models to regenerate articular cartilage and in human models to regenerate bone. Recent research demonstrates that articular cartilage may be able to be repaired via percutaneous introduction of mesenchymal stem cells (MSC’s). Research into MSC’s has exploded in recent years. As an example, a PubMed search for the year 1999 reveals about 90 papers published under the MESH heading of “Mesenchymal Stem Cells”, the same search ran for the year 2007 reveals more than 4,000 entries. The most commonly used source of MSC’s is bone marrow aspirate. Most of the adult bone marrow consists of blood cells in various
Stem cell transplantation for articular cartilage repair
6571216
of every 25,000 children. Chondrodystrophy and achondroplasia are the most common forms of genetic hyaline disorders. Hyaline cartilage caps the long bones and the spinal vertebrae. Most childhood limb growth takes place at the ends of the long bones, not in the shaft. Normally, as a child grows, the most interior portion of the joint cartilage converts into bone, and new cartilage forms on the surface to maintain smooth joints. The old joint margins (edges) reabsorb, so that the overall shape of the joint is maintained as growth continues. Failure of this process throughout the body results in skeletal dysplasia.
Chondrodystrophy
7718861
which gives the new tissue greater growth potential. While there are few long-term studies as of 2018, a history of knee problems and body weight are factors for how well the procedure will work. A 2011 study reported histologically confirmed hyaline cartilage regrowth in the knee. The successful protocol involved arthroscopic microdrilling/ microfracture surgery followed by postoperative injections of autologous peripheral blood progenitor cells (PBPCs) and hyaluronic acid. The procedure creates a blood clot scaffold on which injected PBPCs can be recruited and enhance chondrogenesis at the site of the contained lesion. Knee cartilage replacement therapy Articular cartilage, most notably
Knee cartilage replacement therapy
48497
development of the periosteum. Endochondral ossification occurs in long bones and most other bones in the body; it involves the development of bone from cartilage. This process includes the development of a cartilage model, its growth and development, development of the primary and secondary ossification centers, and the formation of articular cartilage and the epiphyseal plates. Endochondral ossification begins with points in the cartilage called "primary ossification centers." They mostly appear during fetal development, though a few short bones begin their primary ossification after birth. They are responsible for the formation of the diaphyses of long bones, short bones and
Bone
12406602
safety study (n=227) showing fewer complications than would normally be associated with surgical procedures. Another team used a similar technique for cell extraction and ex vivo expansion but cells were embedded within a collagen gel before being surgically re-implanted. They reported a case study in which a full-thickness defect in the articular cartilage of a human knee was successfully repaired. While the use of cultured mesenchymal stem cells has shown promising results, a more recent study using uncultured MSC’s has resulted in full thickness, histologically confirmed hyaline cartilage regrowth. Researchers evaluated the quality of the repair knee cartilage after arthroscopic
Stem cell transplantation for articular cartilage repair
6277379
of the bones in the human body with the highest percentage of its surface area covered by articular cartilage. Additionally, it is also unusual in that it has a retrograde blood supply, i.e. arterial blood enters the bone at the distal end. In humans, no muscles attach to the talus, unlike most bones, and its position therefore depends on the position of the neighbouring bones. Though irregular in shape, the talus can be subdivided into three parts. Facing anteriorly, the head carries the articulate surface of the navicular bone, and the neck, the roughened area between the body and the
Talus bone
5590755
and the cup-like acetabulum of the pelvis. It forms the primary connection between the bones of the lower limb and the axial skeleton of the trunk and pelvis. Both joint surfaces are covered with a strong but lubricated layer called articular hyaline cartilage. The cuplike acetabulum forms at the union of three pelvic bones — the ilium, pubis, and ischium. The Y-shaped growth plate that separates them, the triradiate cartilage, is fused definitively at ages 14–16. It is a special type of spheroidal or ball and socket joint where the roughly spherical femoral head is largely contained within the acetabulum
Hip
4020640
type II collagen and chondroitin sulphate, both of which are also found in elastic cartilage. Hyaline cartilage exists on the ventral ends of ribs, in the larynx, trachea, and bronchi, and on the articulating surfaces of bones. It gives the structures a definite but pliable form. The presence of collagen fibres makes such structures and joints strong, but with limited mobility and flexibility. Hyaline cartilage is the most prevalent type of cartilage. It also forms the temporary embryonic skeleton, which is gradually replaced by bone, and the skeleton of elasmobranch fish. When a thin slice of hyaline cartilage is examined
Hyaline cartilage
4020639
Hyaline cartilage Hyaline cartilage is the glass-like (hyaline) but translucent cartilage found on many joint surfaces. It is also most commonly found in the ribs, nose, larynx, and trachea. Hyaline cartilage is pearl-grey in color, with a firm consistency and has a considerable amount of collagen. It contains no nerves or blood vessels, and its structure is relatively simple. Hyaline cartilage is covered externally by a fibrous membrane known as the perichondrium or, when it's along articulating surfaces, the synovial membrane. This membrane contains vessels that provide the cartilage with nutrition through diffusion. Hyaline cartilage matrix is primarily made of
Hyaline cartilage
6942862
anti-inflammatory medication; drilling of subchondral bone; microfracture; removal or reattachment of loose bodies; mosaicplasty and osteoarticular transfer system (OATS) procedures. The primary goals of treatment are: The articular cartilage's capacity for repair is limited: partial-thickness defects in the articular cartilage do not heal spontaneously, and injuries of the articular cartilage which fail to penetrate subchondral bone tend to lead to deterioration of the articular surface. As a result, surgery is often required in even moderate cases where the osteochondral fragment has not detached from the bone (Anderson Stage II, III). Candidates for non-operative treatment are limited to skeletally immature teenagers
Osteochondritis dissecans
1642198
hyaline cartilage underneath the periosteum on the articulating surface of the condyle. This is the last growth center of bone in the body and is multidirectional in its growth capacity, unlike a typical long bone. This area of cartilage within the bone grows in length by appositional growth as the individual grows to maturity. Over time, the cartilage is replaced by bone, using endochondral ossification. This mandibular growth center in the condyle allows the increased length of the mandible needed for the larger permanent teeth, as well as for the larger brain capacity of the adult. This growth of the
Temporomandibular joint
9483310
time, the clot takes about 8 to 15 weeks for conversion to fibrous tissue and is usually fibrocartilage by about four months post surgery, holding implications for the rehabilitation. Chondrocyte Implantation procedures (CCI), a cell based articular cartilage repair procedure that aims to provide complete hyaline repair tissues for articular cartilage repair, have been posed by some as an alternative to microfracture surgery. In February 2008, Saris "et. al" published a large-scale study claiming that CCI results in better structural repair for symptomatic cartilage defects of the knee than microfracture surgery. According to the study, one year after treatment, the
Microfracture surgery
12388691
as hyaline cartilage). The blood clot takes about 8 weeks to become fibrous tissue and it takes 4 months to become fibrocartilage. This has implications for the rehabilitation. Further on, chances are high that after only 1 or 2 years of the surgery symptoms start to return as the fibrocartilage wears away, forcing the patient to reengage in articular cartilage repair. This is not always the case and microfracture surgery is therefore considered to be an "intermediate" step. An evolvement of the microfracture technique is the implantation of a collagen membrane onto the site of the microfracture to protect and
Articular cartilage repair
4238651
relatively long periods of hyperbaric exposure and aetiology is uncertain. The diagnosis is made by x-ray/MRI appearance and has five juxta-articular classifications and forehead, neck, and shaft classifications indicating early radiological signs. Early on there is flattening of articular surfaces, thinning of cartilage with osteophyte (spur) formation. In juxta-articular lesions without symptoms, there is dead bone and marrow separated from living bone by a line of dense collagen. Microscopic cysts form, fill with necrotic material and there is massive necrosis with replacement by cancellous bone with collapse of the lesions. The following staging system is sometimes useful when managing lesions.
Dysbaric osteonecrosis
7896573
articular surfaces are coated with hyaline cartilage. In the cervical vertebral column, the articular processes collectively form the articular pillars. These are the bony surfaces palpated just lateral to the spinous processes. Articular processes The articular processes or zygapophyses (Greek ζυγον = "yoke" (because it links two vertebrae) + απο = "away" + φυσις = "process") of a vertebra, are projections of the vertebra that serve the purpose of fitting with an adjacent vertebra. The actual region of contact is called the "articular facet". Articular processes spring from the junctions of the pedicles and laminæ, and there are two right
Articular processes
20394158
Nasal chondrocytes Nasal chondrocytes (NC) are present in the hyaline cartilage of the nasal septum, and in fact are the only cell type within the tissue. Similar to chondrocytes present in articular cartilage, NC express extracellular matrix proteins such as glycosaminoglycans and collagen. At birth the nasal septum, except for the vomer ‘’anlage” is completely cartilaginous. In the second half of the first year of life, the septum progressively ossifies in posterior-anterior direction by a process of endochondral ossification.. The remaining cartilaginous part (characterized as hyaline cartilage) of the human nasal septum has a specific three-dimensional organization with regards to
Nasal chondrocytes
15994884
and radiodense foci admixed to speckled calcification. Cortical destruction is a common finding with no soft tissue expansion in many cases. Histopathology of the lesion shows large areas of mature fibrous stroma undergoing hyaline cartilage metaplasia resulting in conspicuous lobules or gradual transformation into chondroid foci. Both hyaline cartilage and chondroid in turn undergo calcification and endochondral cancellous bone formation mimicking epiphyseal plate-like cartilage. Differential diagnosis is concerned with fibrocartilaginous dysplasia of bone, desmoplastic fibroma, low-grade fibrosarcoma, chondromyxoid fibroma and low-grade chondrosarcoma. A full account of imaging findings on radiography, bone scan, CT and magnetic resonance has been provided by
Fibrocartilaginous mesenchymoma of bone
6942859
Harding described the lateral X-ray as a method to identify the site of an OCD lesion. Magnetic resonance imaging (MRI) is useful for staging OCD lesions, evaluating the integrity of the joint surface, and distinguishing normal variants of bone formation from OCD by showing bone and cartilage edema in the area of the irregularity. MRI provides information regarding features of the articular cartilage and bone under the cartilage, including edema, fractures, fluid interfaces, articular surface integrity, and fragment displacement. A low T1 and high T2 signal at the fragment interface is seen in active lesions. This indicates an unstable lesion
Osteochondritis dissecans
18623209
degeneration of articular cartilage is a common disease process in working animals, resulting in osteoarthritis, cartilage is aneural (does not contain nerves) and does not produce pain. Pain associated with osteoarthritis is secondary to joint capsule pain, due to joint distention and reduced range of motion, or to pain from the underlying bone, which may become damaged following erosion of the articular cartilage. Inflammatory products, such as inflammatory mediators and cytokines, damage articular cartilage and have been shown to weaken intra-articular ligaments. Therefore, treatment of joint disease should not only address the primary injury producing inflammation, but also the inflammatory
Treatment of equine lameness
12397028
will gradually worsen and the grade of the lesion or defect will increase. Articular cartilage has a very limited capacity for self repair. Small damage does not repair itself and can often get worse over time. As cartilage is aneural and avascular (lack of nerve and blood supply, respectively), shallow damage often does not trigger pain. When the damage increases and the chondral defect reaches the subchondral bone, the blood supply in the bone starts a healing process in the defect. Scar tissue made up of a type of cartilage called fibrocartilage is then formed. Although fibrocartilage is able to
Articular cartilage damage
6942869
periosteal cells and bone marrow stem cells, as opposed to chondrocytes. These too have demonstrated the ability to regenerate both the cartilage and the underlying subchondral bone. Similar to OATS, arthroscopic articular cartilage paste grafting is a surgical procedure offering cost-effective, long-lasting results for stage IV lesions. A bone and cartilage paste derived from crushed plugs of the non-weight-bearing intercondylar notch can achieve pain relief, repair damaged tissue, and restore function. Some methods of fixation for unstable lesions include countersunk compression screws and Herbert screws or pins made of stainless steel or materials that can be absorbed by the body.
Osteochondritis dissecans
1438871
as the cricoid cartilage and carina. Cartilage is composed of specialized cells called chondrocytes that produce a large amount of collagenous extracellular matrix, abundant ground substance that is rich in proteoglycan and elastin fibers. Cartilage is classified in three types, "elastic cartilage", "hyaline cartilage" and "fibrocartilage", which differ in relative amounts of collagen and proteoglycan. Cartilage does not contain blood vessels (it is avascular) or nerves (it is aneural). Nutrition is supplied to the chondrocytes by diffusion. The compression of the articular cartilage or flexion of the elastic cartilage generates fluid flow, which assists diffusion of nutrients to the chondrocytes.
Cartilage
9483305
Microfracture surgery Microfracture surgery is an articular cartilage repair surgical technique that works by creating tiny fractures in the underlying bone. This causes new cartilage to develop from a so-called super-clot. The surgery is quick (typically lasting between 30–90 minutes), minimally invasive, and can have a significantly shorter recovery time than an arthroplasty (knee replacement). Chronic articular cartilage defects do not heal spontaneously. However, acute traumatic osteochondral lesions or surgically created lesions extending into subchondral bone, e.g. by Pridie drilling, spongialization abrasion or microfracture causing the release of multipotent mesenchymal stem cells from the bone marrow, may heal with repair
Microfracture surgery
1801475
they form a loose aggregate of cells, interspersed with small blood vessels, known as granulation tissue. Osteoclasts move in to reabsorb dead bone ends, and other necrotic tissue is removed. Seven to nine days after fracture, the cells of the periosteum replicate and transform. The periosteal cells proximal to (on the near side of) the fracture gap develop into chondroblasts, which form hyaline cartilage. The periosteal cells distal to (at the far end of) the fracture gap develop into osteoblasts, which form woven bone through bone resorption of calcified cartilage and recruitment of bone cells and osteoclasts. The fibroblasts within
Bone healing
6942844
Osteochondritis dissecans Osteochondritis dissecans (OCD or OD) is a joint disorder in which cracks form in the articular cartilage and the underlying subchondral bone. OCD usually causes pain and swelling of the affected joint which catches and locks during movement. Physical examination typically reveals an effusion, tenderness, and a crackling sound with joint movement. OCD is caused by blood deprivation in the subchondral bone. This loss of blood flow causes the subchondral bone to die in a process called avascular necrosis. The bone is then reabsorbed by the body, leaving the articular cartilage it supported prone to damage. The result
Osteochondritis dissecans
14476711
sacroiliac joint. Each hip bone is connected to the corresponding femur (thigh bone) (forming the primary connection between the bones of the lower limb and the axial skeleton) through the large ball and socket joint of the hip. The hip bone is formed by three parts: ilium, ischium, and pubis. At birth, these three components are separated by hyaline cartilage. They join each other in a Y-shaped portion of cartilage in the acetabulum. By the end of puberty the three regions will have fused together, and by the age of 25 they will have ossified. The two hip bones join
Hip bone
20394160
chondrocytes have typically been the cell type used for cartilage tissue engineering strategies for articular cartilage repair. Since NC can also express hyaline cartilage specific extracellular matrix proteins such as glycosaminoglycans and collagen, NC have recently also been used for the in vitro engineering of cartilage tissues. Harvesting of nasal cartilage is minimally invasive, can be performed in an outpatient procedure under local anesthesia and is associated with minimal morbidity. NC can be isolated from nasal septal cartilage biopsies by enzymatic digestion using collagenase type I, II or IV (at different combination and concentration – varying from 0.15% to 0.6%
Nasal chondrocytes
16712612
a continuous passive motion machine for 6 hours a night for 4 weeks. If the defect is in a weight-bearing region, weight-bearing is restricted for 4 weeks. A guided physical therapy program begins on postoperative day 1. In a 2 to 12 year follow-up of 125 patients, pain, functioning, and activity measures improved in 82% of patients. Eighteen of the 125 patients (14.4%) were considered failures. Histologically, 42 of 66 (63.6%) of biopsies showed strong evidence of replacement of their articular surface, and 18 of 66 biopsies (27.3%) showed development of normal looking hyaline cartilage. Paste grafting is a relatively
Articular cartilage stem cell paste grafting
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suprapatellar bursa described above. Four considerably smaller bursae are located on the back of the knee. Two non-communicative bursae are located in front of the patella and below the patellar tendon, and others are sometimes present. Cartilage is a thin, elastic tissue that protects the bone and makes certain that the joint surfaces can slide easily over each other. Cartilage ensures supple knee movement. There are two types of joint cartilage in the knees: fibrous cartilage (the meniscus) and hyaline cartilage. Fibrous cartilage has tensile strength and can resist pressure. Hyaline cartilage covers the surface along which the joints move.
Knee
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Meckel's cartilage. In tetrapods the cartilage partially ossifies (changes to bone) at the rear end of the jaw and becomes the articular bone, which forms part of the jaw joint in all tetrapods except mammals. Fish jaw Most bony fishes have two sets of jaws made mainly of bone. The primary oral jaws open and close the mouth, and a second set of pharyngeal jaws are positioned at the back of the throat. The oral jaws are used to capture and manipulate prey by biting and crushing. The pharyngeal jaws, so-called because they are positioned within the pharynx, are used
Fish jaw
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Cartilage will wear over the years. Cartilage has a very limited capacity for self-restoration. The newly formed tissue will generally consist of a large part of fibrous cartilage of lesser quality than the original hyaline cartilage. As a result, new cracks and tears will form in the cartilage over time. The articular disks of the knee-joint are called menisci because they only partly divide the joint space. These two disks, the medial meniscus and the lateral meniscus, consist of connective tissue with extensive collagen fibers containing cartilage-like cells. Strong fibers run along the menisci from one attachment to the other,
Knee
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has a good temperament that will tolerate the months of inactivity required for healing. Fractures that are open, comminuted (very fragmented), or located higher on the limb tend to have a poorer prognosis. Lameness is most commonly associated with injury to synovial joints, or those joints containing articular cartilage, a joint capsule, and a synovial membrane. Joint disease may affect the joint capsule and synovial membrane, articular cartilage, subchondral bone (the bone underneath the cartilage), menisci, or any ligaments associated with the joint. Damage to any of these tissues leads to inflammation, which is especially problematic in the joint. While
Treatment of equine lameness
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bone and cartilage is removed from the joint. Then a new healthy dowel of bone with its cartilage covering is punched out of the same joint and replanted into the hole left from removing the old damaged bone and cartilage. The healthy bone and cartilage are taken from areas of low stress in the joint so as to prevent weakening the joint. Depending on the severity and overall size of the damage multiple plugs or dowels may be required to adequately repair the joint, which becomes difficult for Osteochondral Autografts. The clinical results may deteriorate over time. For Osteochondral Allografts
Articular cartilage repair
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in order to do this. Natural articular cartilage is an inhomogeneous, anisotropic, and viscoelastic tissue. The structure, described above 1.1.2. allows the cartilaginous tissue to have superior mechanical properties in order to perform the functions necessary. Synthetic cartilage will attempt to mimic the functional properties of natural cartilage, which can be broken down into two main aspects. These are important functions of cartilage because of its role as a cushion in bone articulation. When damage and degradation occurs to the articular cartilage, it can no longer withstand the large loads without pain and discomfort of the individual due to the
Artificial cartilage
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microdrilling (also microfracture) surgery followed by post-operative injections of autologous peripheral blood progenitor cells (PBPC) in combination with hyaluronic acid(HA). Stem cell transplantation for articular cartilage repair Mesenchymal stem cells (MSCs) are multipotent cells found in multiple human adult tissues including bone marrow, synovial tissues, and adipose tissues. Since they are derived from the mesoderm, they have been shown to differentiate into bone, cartilage, muscle, and adipose tissue. MSCs from embryonic sources have shown promise scientifically while creating significant controversy. As a result, many researchers have focused on adult stem cells, or stem cells isolated from adult humans that can
Stem cell transplantation for articular cartilage repair
12406596
Stem cell transplantation for articular cartilage repair Mesenchymal stem cells (MSCs) are multipotent cells found in multiple human adult tissues including bone marrow, synovial tissues, and adipose tissues. Since they are derived from the mesoderm, they have been shown to differentiate into bone, cartilage, muscle, and adipose tissue. MSCs from embryonic sources have shown promise scientifically while creating significant controversy. As a result, many researchers have focused on adult stem cells, or stem cells isolated from adult humans that can be transplanted into damaged tissue. Because of their multi-potent capabilities, mesenchymal stem cell (MSC) lineages have been used successfully in
Stem cell transplantation for articular cartilage repair
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Articular cartilage damage Cartilage structures and functions can be damaged. Such damage can result from a variety of causes, such as a bad fall or traumatic sport-accident, previous knee injuries or wear and tear over time. Immobilization for long periods can also result in cartilage damage. Articular cartilage damage in the knee may be found on its own but it will more often be found in conjunction with injuries to ligaments and menisci. People with previous surgical interventions face more chances of articular cartilage damage due to altered mechanics of the joint. Articular cartilage damage may also be found in
Articular cartilage damage
16950310
vivo gene therapy. This method of gene therapy is more complicated but safer since it is possible to culture, test, and control the modified cells. Osteoarthritis (OA) is a degenerative joint disease which is the western world's leading cause of pain and disability. It is characterized by the progressive loss of normal structure and function of articular cartilage, the smooth tissue covering the end of the moving bones. This chronic disease not only affects the articular cartilage but the subchondral bone, the synovium and periarticular tissues are other candidates. People with OA can experience severe pain and limited motion. OA
Gene therapy for osteoarthritis
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proportion may not feel benefit. The hip is essentially a ball and socket joint. It consists of the head of the femur (the ball) and the acetabulum (the socket). Both the ball and socket are congruous and covered with hyaline (or articular) cartilage, which allows smooth, almost frictionless gliding between the two surfaces. The edge of the acetabulum is surrounded by the "acetabular labrum", a fibrous structure that envelops the femoral head. (See fig. 1) The labrum acts as a seal, or gasket, around the femoral head. However, this is not its only function, as it has been shown to
Hip arthroscopy
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Sternoclavicular joint The sternoclavicular joint or sternoclavicular articulation is the joint between the manubrium of the sternum and the clavicle bone. It is structurally classed as a synovial saddle joint and functionally classed as a diarthrosis and multiaxial joint. It is composed of two portions separated by an articular disc of fibrocartilage. The bone areas entering into its formation are the sternal end of the clavicle, the upper and lateral part of the sternum, (the clavicular notch), and the cartilage of the first rib, visible from the outside as the suprasternal notch. The articular surface of the clavicle is much
Sternoclavicular joint
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painful and has a very short recovery period. This alternative to the current available treatments was shown not to cause cancer in patients who were followed for 3 years after the procedure. See also Autologous Mesenchymal Stem Cell Transplant for Cartilage Growth Rehabilitation following any articular cartilage repair procedure is paramount for the success of any articular cartilage resurfacing technique. The rehabilitation is often long and demanding. The main reason is that it takes a long time for the cartilage cells to adapt and mature into repair tissue. Cartilage is a slow adapting substance. Where a muscle takes approximately 35
Articular cartilage repair
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Nasal septum The nasal septum () separates the left and right airways in the nose, dividing the two nostrils. It is depressed by the depressor septi nasi muscle. The fleshy external end of the nasal septum is called the "columella nasi" or just columella, and is made up of cartilage and soft tissue. The nasal septum contains bone and hyaline cartilage. It is normally about 2 mm thick. The nasal septum is composed of five structures: At an early period the septum of the nose consists of a plate of cartilage, known as the "ethmovomerine cartilage." The postero-superior part of
Nasal septum
9703206
bone is covered with articular cartilage, which makes it difficult to gain access to the scaphoid. Fractures of the scaphoid are common in young males. They are less common in children and older adults because the distal radius is weaker contributor to the wrist and more likely to fracture in these age groups. Scaphoid fractures account for 50%-80% of carpal injuries. These are also called navicular fractures (the scaphoid also being called the carpal navicular), although this can be confused with the navicular bone in the foot. Scaphoid fracture A scaphoid fracture is a break of the scaphoid bone in
Scaphoid fracture
2533945
of the wrist, and articulates with the radius, lunate, trapezoid, trapezium and capitate. Over 80% of the bone is covered in articular cartilage. The palmar surface of the scaphoid is concave, and forming a tubercle, giving attachment to the transverse carpal ligament. The proximal surface is triangular, smooth and convex, and articulates with the radius and adjacent carpal bones, namely the lunate, capitate, trapezium and trapezoid. The lateral surface is narrow and gives attachment to the radial collateral ligament. The medial surface has two facets, a flattened semi-lunar facet articulating with the lunate bone, and an inferior concave facet, articulating
Scaphoid bone
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Articular cartilage injuries Cartilage structures and functions can relatively easily be harmed, often resulting in damage. Such damage can result from a variety of causes, resulting from a bad fall or sport-accident (traumatic), previous knee injuries (post-traumatic) or wear and tear over time. Immobilization for long periods can also result in cartilage damage. Articular cartilage damage might be found on its own but it will more often be found in conjunction with injuries to ligaments and menisci. People with previous repairs to ligaments and or menisci often face greater chances of new articular cartilage damage due to altered mechanics in
Articular cartilage injuries
20394170
II clinical trial was initiated and is currently ongoing to assess the efficacy of the NC-based cartilage grafts for the repair of traumatic knee cartilage defects (BIO-CHIP; funded by the European Union through the Horizon 2020 program, grant number 681103). Nasal chondrocytes Nasal chondrocytes (NC) are present in the hyaline cartilage of the nasal septum, and in fact are the only cell type within the tissue. Similar to chondrocytes present in articular cartilage, NC express extracellular matrix proteins such as glycosaminoglycans and collagen. At birth the nasal septum, except for the vomer ‘’anlage” is completely cartilaginous. In the second half
Nasal chondrocytes
9483309
success. A couple of physicians are promoting an alternative treatment implanting autologous mesenchymal stem cells directly into the cartilage defect, without having to penetrate the subchondral bone. Studies have shown that microfracture techniques do not fill in the chondral defect fully, forming fibrocartilage rather than hyaline cartilage. Fibrocartilage is not as mechanically sound as hyaline cartilage; it is much denser and unable to withstand the demands of everyday activities as well as the original cartilage and is thus at higher risk of breaking down. The blood clot is very delicate after surgery and needs to be protected. In terms of
Microfracture surgery
7718855
Knee cartilage replacement therapy Articular cartilage, most notably that which is found in the knee joint, is generally characterized by very low friction, high wear resistance, and poor regenerative qualities. It is responsible for much of the compressive resistance and load bearing qualities of the knee joint and, without it, walking is painful to impossible. Osteoarthritis is a common condition of cartilage failure that can lead to limited range of motion, bone damage and invariably, pain. Due to a combination of acute stress and chronic fatigue, osteoarthritis directly manifests itself in a wearing away of the articular surface and, in
Knee cartilage replacement therapy
7525196
ends in a rounded eminence, the articular tubercle (eminentia articularis). This tubercle forms the front boundary of the mandibular fossa, and in the fresh state is covered with cartilage. In front of the articular tubercle is a small triangular area which assists in forming the infratemporal fossa; this area is separated from the outer surface of the squamous part by a ridge which is continuous behind with the anterior root of the zygomatic process, and in front, in the articulated skull, with the infratemporal crest on the great wing of the sphenoid. Between the posterior wall of the external acoustic
Squamous part of temporal bone
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but their use is still expensive and time consuming. X-rays show only bone injuries and are therefore not very helpful in diagnosing cartilage damage, especially not in early stages. The best tool for diagnosing articular damage is the use of arthroscopy. The International Cartilage Repair Society has set up an arthroscopic grading system by which cartilage defects can be ranked: Doctors will often also measure the size of each defect. Defects smaller than 2 cm, for example, are considered to be small. It is also important to remember that although the amount of damage is an important factor, the location
Articular cartilage damage
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Synchondrosis Where the connecting medium is hyaline cartilage, a cartilaginous joint is termed a synchondrosis. An example of a synchondrosis joint is the first sternocostal joint (where the first rib meets the manubrium). In this example, the rib articulates with the manubrium via the costal cartilage. (The rest of the sternocostal joints are synovial plane joints.) Sometimes, this is a temporary form of joint called epiphyseal growth plate, where the cartilage is converted into bone before adult life. Such joints are found between the epiphyses and diaphyses of long bones, between the occipital and the sphenoid, and for some years
Synchondrosis
13068799
stem cell with shell graft approach to replacing the articular cartilage surface of the knee. Allison Gannet, a World Cup freeskier Champion, had had 7 previous knee surgeries before having a biological joint replacement, with Stone as her surgeon. This procedure included the articular cartilage paste grafting procedure, and following, Gannet reported being pain free for the first time in 8 years. Xenograft ligament cartilage, bone, and tendon transplantation. FDA-Approved ACL Replacement Study 2003 - PRESENT CE Mark issued April 2014. Stone's experience with collagen scaffolds sourced from bovine Achilles tendons led him to focus on other animal tissues that
Kevin R. Stone
12676432
is defined as trochlear dysplasia. Not having a groove because the trochlear bone has flattened out can cause the patella to slide because nothing is holding the patella in place. Patellar dislocations occur by: The patella is a triangular sesamoid bone which is embedded in tendon. It rests in the patellofemoral groove, an articular cartilage-lined hollow at the end of the thigh bone (femur) where the thigh bone meets the shin bone (tibia). Several ligaments and tendons hold the patella in place and allow it to move up and down the patellofemoral groove when the leg bends. The top of
Patellar dislocation
2764821
the rest of the cartilage to enter the middle ear where it becomes the incus. Quadrate bone The quadrate bone is part of a skull in most tetrapods, including amphibians, sauropsids (reptiles, birds), and early synapsids. In these animals it connects to the quadratojugal and squamosal in the skull, and forms part of the jaw joint (the other part is the articular bone at the rear end of the lower jaw). It is formed by endochondral ossification and is formed from the hindmost part of the primitive cartilaginous upper jaw. In snakes, the quadrate bone has become elongated and very
Quadrate bone
7718856
extreme cases, bone can be exposed in the joint. Some additional examples of cartilage failure mechanisms include cellular matrix linkage rupture, chondrocyte protein synthesis inhibition, and chondrocyte apoptosis. There are several different repair options available for cartilage damage or failure. "Maci" or autologous cultured chondrocytes on porcine collagen membrane, is a treatment to correct cartilage defects in the knee. This treatment has been approved by the Food and Drug Administration in 2016 for adult treatment only. Autologous matrix-induced chondrogenesis, which is also known as AMIC, is a biological treatment option for articular cartilage damage bone marrow stimulating technique in combination
Knee cartilage replacement therapy
15653895
turn carries on downwards into the femur, or thighbone, itself. A bony protrusion or bump at the head-neck junction has been likened to a cam, an eccentric part of a rotating device. This leads to joint damage as a result of the non-spherical femoral head being forced into the acetabulum mainly with flexion and/or internal rotation. This may impart compression and shear forces to the articular cartilage, and may lead to labral tears and peeling away of the articular cartilage from the underlying bone, so-called cartilage delamination (see fig. 8). Standard arthroscopic treatment of symptomatic cam FAI involves debridement (resection)
Hip arthroscopy
3838726
carcinoma. A nasal septum piercing is usually carried out through the fleshy columella close to the end of the nasal septum. Nasal septum The nasal septum () separates the left and right airways in the nose, dividing the two nostrils. It is depressed by the depressor septi nasi muscle. The fleshy external end of the nasal septum is called the "columella nasi" or just columella, and is made up of cartilage and soft tissue. The nasal septum contains bone and hyaline cartilage. It is normally about 2 mm thick. The nasal septum is composed of five structures: At an early
Nasal septum
1801477
hyaline cartilage. The lamellar bone begins forming soon after the collagen matrix of either tissue becomes mineralized. At this stage, the process is induced by IL-1 and TNFα. The mineralized matrix is penetrated by microvessel and numerous osteoblasts. The osteoblasts form new lamellar bone upon the recently exposed surface of the mineralized matrix. This new lamellar bone is in the form of trabecular bone. Eventually, all of the woven bone and cartilage of the original fracture callus is replaced by trabecular bone, restoring most of the bone's original strength. Remodeling begins as early as three to four weeks after fracture
Bone healing
12388693
and his team propose that the microdrilling surgery creates a blood clot scaffold on which injected PBPC’s can be recruited and enhance chondrogenesis at the site of the contained lesion. They explain that the significance of this cartilage regeneration protocol is that it is successful in patients with historically difficult-to-treat grade IV bipolar or bone-on-bone osteochondral lesions. Saw and his team are currently conducting a larger randomized trial and working towards beginning a multicenter study. The work of the Malaysian research team is gaining international attention. This technique/repair requires transplant sections of bone and cartilage. First, the damaged section of
Articular cartilage repair
7525198
from the external acoustic meatus; it is divided into two parts by a narrow slit, the petrotympanic fissure (Glaserian fissure). The anterior part, formed by the squamous part, is smooth, covered in the fresh state with cartilage, and articulates with the condyle of the mandible. Behind this part of the fossa is a small conical eminence; this is the representative of a prominent tubercle which, in some mammals, descends behind the condyle of the mandible, and prevents its backward displacement. The posterior part of the mandibular fossa, formed by the tympanic part of the bone, is non-articular, and sometimes lodges
Squamous part of temporal bone
6942868
of the reparative fibrocartilage, new techniques have been designed to fill the defect with tissue that more closely simulates normal hyaline articular cartilage. One such technique is autologous chondrocyte implantation (ACI), which is useful for large, isolated femoral defects in younger people. In this surgery, chondrocytes are arthroscopically extracted from the intercondylar notch of the articular surface. The chondrocytes are grown and injected into the defect under a periosteal patch. ACI surgery has reported good to excellent results for reduced swelling, pain and locking in clinical follow-up examinations. However, some physicians have preferred to use undifferentiated pluripotential cells, such as
Osteochondritis dissecans
2070374
the glenoid cavity, acromion and coracoid processes. The main joint of the shoulder is the shoulder joint (or glenohumeral joint), between the humerus and the glenoid process of the scapular. The acromioclavicular joint and sternoclavicular joint also play a role in shoulder movements. White hyaline cartilage on the ends of the bones (called articular cartilage) allows the bones to glide and move on each other, and the joint space is surrounded by a synovial membrane. Around the joint space are muscles - the rotator cuff, which directly surrounds and attaches to the shoulder joint - and other muscles that help
Shoulder
2489593
torn all the way down to the bone, the blood supply from inside the bone is sometimes enough to start some healing inside the lesion. In cases like this, the body will form a scar in the area using a special type of cartilage called fibrocartilage. Fibrocartilage is a tough, dense, and fibrous material that helps fill in the torn part of the cartilage; however, it is not an ideal replacement for the smooth, glassy articular cartilage that normally covers the surface of joints. Degeneration of fibrocartilage is seen in degenerative disc disease. Fibrocartilage White fibrocartilage consists of a mixture
Fibrocartilage
8912691
after birth, between the petrous portion of the temporal and the jugular process of the occipital bone. Synchondrosis Where the connecting medium is hyaline cartilage, a cartilaginous joint is termed a synchondrosis. An example of a synchondrosis joint is the first sternocostal joint (where the first rib meets the manubrium). In this example, the rib articulates with the manubrium via the costal cartilage. (The rest of the sternocostal joints are synovial plane joints.) Sometimes, this is a temporary form of joint called epiphyseal growth plate, where the cartilage is converted into bone before adult life. Such joints are found between
Synchondrosis
20858630
This sign is 83% sensitive and 100% specific forthrombotic occlusionof the internal carotid artery. It can detect hemosiderin deposition in joints as seen in arthropathy by hemophilia, as well as pigmented villonodular synovitis . T2*-weighted sequences are very useful for evaluation of articular cartilages and ligaments because a relatively long T2* makes the articular cartilage becomes more hyperintense, while bone becomes hypointense. T2*-weighted sequences can be used with MRI contrast, mainly ferucarbotran or superparamagnetic iron oxide (SPIO), to depict liver lesions. T2*-weighted imaging T2*-weighted imaging is an MRI sequence to quantify effective T2 (T2* or "T2-star"). In this sequence, hemorrhages
T2*-weighted imaging
12388692
stabilize the blood clot and to enhance the chondrogenic differentiation of the MSCs. This technique is known as AMIC (Autologous Matrix-Induced Chondrogenesis) and was first published in 2003. A 2011 study reports histologically confirmed hyaline cartilage regrowth in a 5 patient case-series, 2 with grade IV bipolar or kissing lesions in the knee. The successful protocol involves arthroscopic microdrilling/ microfracture surgery followed by postoperative injections of autologous peripheral blood progenitor cells (PBPC's) and hyaluronic acid (HA). PBPC’s are a blood product containing mesenchymal stem cells and is obtained by mobilizing the stem cells into the peripheral blood. Khay Yong Saw
Articular cartilage repair
6942853
subsequent trauma. High-impact sports such as gymnastics, soccer, basketball, lacrosse, football, tennis, squash, baseball and weight lifting may put participants at a higher risk of OCD in stressed joints (knees, ankles and elbows). Recent case reports suggest that some people may be genetically predisposed to OCD. Families with OCD may have mutations in the aggrecan gene. Studies in horses have implicated specific genetic defects. Osteochondritis dissecans differs from "wear and tear" degenerative arthritis, which is primarily an articular surface problem. Instead, OCD is a problem of the bone underlying the cartilage, which may secondarily affect the articular cartilage. Left untreated,
Osteochondritis dissecans
13686145
surgery. Eirik Solheim Eirik Johan Solheim (born August 20, 1960) is a Norwegian professor in orthopaedic surgery at the University of Bergen in Norway. Eirik Johan Solheim defended his doctoral thesis "Effects of Bioerodible Polyorthoester on Heterotopic and Orthotopic Bone Induction in Rats" at the University of Oslo in 1993. He did his specialist training for orthopedic surgery at Hagavik Hospital, Haukeland Universitetssykehus og Haraldsplass Deaconess Hospital. Dr. Solheim has authored or co-authored three books and about 60 scholarly articles and monographs on various orthopedic topics. Much of his scientific work relates to osteogenesis, articular cartilage lesions and articular cartilage
Eirik Solheim
13686144
Eirik Solheim Eirik Johan Solheim (born August 20, 1960) is a Norwegian professor in orthopaedic surgery at the University of Bergen in Norway. Eirik Johan Solheim defended his doctoral thesis "Effects of Bioerodible Polyorthoester on Heterotopic and Orthotopic Bone Induction in Rats" at the University of Oslo in 1993. He did his specialist training for orthopedic surgery at Hagavik Hospital, Haukeland Universitetssykehus og Haraldsplass Deaconess Hospital. Dr. Solheim has authored or co-authored three books and about 60 scholarly articles and monographs on various orthopedic topics. Much of his scientific work relates to osteogenesis, articular cartilage lesions and articular cartilage repair
Eirik Solheim
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(knee replacement) surgery. Articular cartilage repair treatments help patients to return to their original lifestyle; regaining mobility, going back to work and even practicing sports again. Though the different articular cartilage procedures differ in the used technologies and surgical techniques, they all share the aim to repair articular cartilage whilst keeping options open for alternative treatments in the future. Broadly taken, there are five major types of articular cartilage repair: Arthroscopic lavage is a "cleaning up" procedure of the knee joint. This short term solution is not considered an articular cartilage repair procedure but rather a "palliative treatment" to reduce
Articular cartilage repair
6942845
is fragmentation (dissection) of both cartilage and bone, and the free movement of these bone and cartilage fragments within the joint space, causing pain and further damage. OCD can be difficult to diagnose because these symptoms are found with other diseases. However, the disease can be confirmed by X-rays, computed tomography (CT) or magnetic resonance imaging (MRI) scans. Non-surgical treatment is rarely an option as the ability for articular cartilage to heal is limited. As a result, even moderate cases require some form of surgery. When possible, non-operative forms of management such as protected reduced or non-weight bearing and immobilization
Osteochondritis dissecans
11073089
ribs. Known as "symphysis". Fibrocartilaginous and hyaline joints, usually occurring in the midline. Examples in human anatomy would be the manubriosternal joint (between the manubrium and the sternum), intervertebral discs, and the pubic symphysis. Articulating bones at a symphysis are covered with hyaline cartilage and have a thick, fairly compressible pad of fibrocartilage between them. Cartilaginous joints allow little movement, as summarized above. Cartilaginous joint Cartilaginous joints are connected entirely by cartilage (fibrocartilage or hyaline). Cartilaginous joints allow more movement between bones than a fibrous joint but less than the highly mobile synovial joint. Cartilaginous joints also forms the growth
Cartilaginous joint
6942867
arthroscopic drilling, abrasion, and microfracturing. In 1946, Magnusson established the use of stem cells from bone marrow with the first surgical debridement of an OCD lesion. These cells typically differentiate into fibrocartilage and rarely form hyaline cartilage. While small lesions can be resurfaced using this form of surgery, the repair tissue tends to have less strength than normal hyaline cartilage and must be protected for 6 to 12 months. Results for large lesions tend to diminish over time; this can be attributed to the decreased resilience and poor wear characteristics of the fibrocartilage. In attempts to address the weaker structure
Osteochondritis dissecans