Portal de Periódicos da CAPES

Cartilagem Articular e Osteoartrose

2000; Brazilian Society of Orthopedics and Traumatology; Volume: 8; Issue: 2 Linguagem: Inglês

10.1590/s1413-78522000000200005

2176-7521

Márcia Uchôa of Rezende, Arnaldo José Hernandez, Gilberto Luís Camanho, Marco Martins Amatuzzi,

Bone health and treatments

Currently, the mechanical degenerative changes of the articularcartilage are one of the primary concerns among orthopedicexperts.Both the difficulty in establishing experimental models of arthrosisand the regular observation of secondary arthritic phenomena intypically orthopedic diseases - like sequelae from fractures andarticular instability - are aspects which close the orthopedist to thestudy of the cartilage and its physiology.The objectivity of orthopedics becomes this interest andproximity hard. The study of either the cartilage biology or itsstructure and degeneration is based on concepts few common toour literature. However, the knowledge of the pathophysiology ofthe osteoarthrosis has demonstrated that a biological solution isvery close, especially in the initial cases. The use of eithertherapeutically or preventively systemic or intra-articular drugs isalready incorporated in our arsenal.The aim of this review article is to offer briefly to the orthopedistthe study of the cartilage physiology and the osteoarthrosispathophysiology.THE NORMAL ARTICULAR CARTILAGEIt is known that the articular cartilage is an avascular and poorlycellular tissue, whose biochemical characteristics reflect mainlythe composition of the extracellular matrix (Lanzer & Komenda,1990). The extracellular matrix is hyperhydrated (the water contentranges from 66% to 80%), with 20%-34% of solid components,5%-6% of which is inorganic components (hydroxyapatite). Amongthe remaining organic content, 48%-62% is formed by type-IIcollagen and 22%-38% is formed by proteoglycan. The rigidityand elasticity of the tissue are consequence of the relativedecompressibility of the proteoglycan molecules. The thick bundleof collagen fibers underlying and paralleled to the articular surfaceform a “skin” and probably serve not only as a restrictive layer butalso as a distributor of compression strengths. The fibers of thecartilage basal layer are perpendicular to the surface and theyserve as an anchor, which fasten the decalcificated cartilage tothe calcified zone and perhaps to the subchondral bone. In theintermediate zones, the fibers are randomly disposed. The oblique