BASIC SCIENCE OF JOINTS

III

Joints
1. Articular tissues
a. Cartilage
b. Synovium
c. Meniscus
2. Arthroses

CARTILAGE
Type of cartilage
a. Growth plate ( physeal ) cartilage
b. Fibrocartilage : tendon and ligament
insertion into bone
c. Elastic cartilage ( trachea )
d. Fibroelastic cartilage ( menisci)
e. Articular cartilage.

ARTICULAR CARTILAGE
Function
decreases in friction and distributes loads
Characteristic
Avascular , aneural and alymphatic.
PH: 7,4
Composition
a. Water (65-80% of wet weight) for nutrition and
lubrication,allow deformation of cartilage surface in response to
stress.
b. Collagen collagen type 2, provide cartilaginous framework and
tensile strength, half life 25 years
c. Proteoglycan produced by chondrocytes, provide compressive
strength ,

 Proteoglycans are secreted into extracellular

matrix composed as glycosaminoglycans
(GAGs)
GAGs subtype chodroitin sulfate and
keratin sulfate
Proteoglycans half life of 3 months.
Proteoglycans provide elastic strength ,
produce cartilages porous structure and trap
and hold water.

D. Chondrocytes produce collagen ,

proteogylcan and enzymes for cartilage
metabolism
E. Other matrix components :
1. adhesives : fibronectin , chondronectin ,
anchorin
2. lipids

ARTICULAR CARTILAGE LAYER

A.
B.
C.
D.
E.

Gliding zone( super

Transitional zone( middle )
Radial zone ( deep)
Tide mark
Calcified zone

Articular Cartilage Metabolism

1.
2.
3.
4.

Collagen synthesis .
Collagen catabolism enzymatic processes
Proteoglycan sintesis.
Proteoglycan catabolism.

Articular Cartilage Growth Factor

1. PDGF healing of cartilage laceration
2. TGF- stimulates proteoglycan synthesis
while suppressing syhthesis of type II
collagen
3. Fibroblast growth factor stimulates DNA
synthesis in adult articular chondrocytes.
4. Insulin-like Growth factor I (IGF-I)
stimulate DNA and cartilage matrix synthesis
in adult articular.

ARTICULAR CARTILAGE HEALING

The fibrocartilage is produced by
undiffrentiated marrow mesencyhmal stem
cell.
Injury of articular cartilage
1. Type 1 injury: limited due to chondrocytes
2. Type 2 injury : articular surface do not cross
the tide mark
3. Type 3 injury : laceration extend below
tidemark

SYNOVIUM
Types
Type A : fagosit
Type B : produce syonovial fluid , fibroblastlike cells
Type C : intermediate cell type
Components and function
Synovial fluid consists : hyaluronic acid ,
lubricin , proteinase, collagenasse and
prostaglandin

SYNOVIUM
FUNCTION
1. Lumbricate articular cartilage lubricin
2. Provides nourishment through diffusion
HISTOLOGY
Chronic inflammation of synovium accumulation of
lymphocytes , hyperplasia intima lining, neutrphils
absence.

MENISCUS
Deepens the articular surface of a variety
synovial joints .
More elastic and less permeable than articular cartilage,
triangular semilunar structure.
Meniscus transmits 50% of the force across the jointwhen
the knee is extended and up to 90 % in deep flexion.
Meniscus composed fibroelastic cartilage , collagen fiber
(type 1), proteoglycans glcoprotein and cellular elements.
The cell responsible for menischal healing is the
fibrochondrocyte.
Peripheral acute meniscal tears width < 4 mm have the best
healing characteristics