Why can’t cartilage heal itself?

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Why can’t cartilage heal itself?



Buckwalter and colleagues in an article in Arthritis and Rheumatism commented, “articular cartilage does not readily repair itself following injury. With pure cartilage injuries the absence of a direct blood supply means that reparative cells cannot reach the injured areas. Neither do surrounding chondrocytes migrate into cartilage defects and produce a reparative matrix. Repair relies on the multiplication potential of chondrocytes and a short lived increase in metabolic products, chiefly collagen and proteoglycans. However chondrocytes have low multiplication potential. There is however some attempt at repair when cartilage damage breaks through to the underlying subchondral bone. A primitive mesenchymal blood clot forms leading to the production of fibrocartilage. This fibrocartilage has inferior biomechanical properties to hyaline cartilage and is the basis for marrow stimulation techniques such as microfracture.

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