Buckwalter Joseph A, Mankin Henry J, Grodzinsky Alan J
Department of Orthopaedics, University of Iowa, Iowa City, USA.
Instr Course Lect. 2005;54:465-80.
Articular cartilage, which makes possible the painless, low-friction movement of synovial joints, consists of a sparsely distributed population of highly specialized cells called chondrocytes that are embedded within a matrix and provide articular cartilage with remarkable mechanical properties. Chondrocytes form the tissue matrix macromolecular framework from three classes of molecules: collagens, proteoglycans, and noncollagenous proteins. The matrix protects the cells from injury resulting from normal joint use, determines the types and concentrations of molecules that reach the cells, acts as a mechanical signal transducer for the cells, and helps maintain the chondrocyte phenotype. Throughout life, articular cartilage undergoes internal remodeling as the cells replace matrix macromolecules lost through degradation. Aging decreases the ability of chondrocytes to maintain and restore articular cartilage and thereby increases the risk of degeneration of the articular cartilage surface. Progressive degeneration of articular cartilage leads to joint pain and dysfunction that is clinically identified as osteoarthritis. Investigation regarding the pathogenesis of posttraumatic osteoarthritis, the form of osteoarthritis that develops following joint injury, is helping to explain the development and progression of joint degeneration.
关节软骨使滑膜关节能够进行无痛、低摩擦的运动,它由一种分布稀疏的高度特化细胞群组成,这些细胞称为软骨细胞,它们嵌入基质中,赋予关节软骨卓越的力学性能。软骨细胞由三类分子构成组织基质大分子框架:胶原蛋白、蛋白聚糖和非胶原蛋白。该基质保护细胞免受正常关节活动造成的损伤,决定到达细胞的分子类型和浓度,作为细胞的机械信号转导器,并有助于维持软骨细胞表型。在整个生命过程中,随着细胞替换因降解而丢失的基质大分子,关节软骨会进行内部重塑。衰老会降低软骨细胞维持和修复关节软骨的能力,从而增加关节软骨表面退变的风险。关节软骨的进行性退变会导致关节疼痛和功能障碍,临床上将其诊断为骨关节炎。关于创伤后骨关节炎(即关节损伤后发生的骨关节炎形式)发病机制的研究,有助于解释关节退变的发生和发展。
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