Knee Health Promotion Option for Osteoarthritic Knee: Cartilage Regeneration is Possible

Abstract

Although articular hyaline cartilage was typically considered having no or low potential for regeneration (Zhang L et al., 2009), some still thought that it does have the capacity to grow and remodel extensively during preand post-natal development and after trauma (Onyekwelu I et al., 2009). Both direct and indirect evidence of articular cartilage regeneration have been observed by some authors after correction of varus deformity for osteoarthritis of the knee (Kanamiya T et al., 2002; Koshino T et al., 2003). Moreover, unlike the first impression of a more or less static tissue, articular cartilage shows a slow turnover. Anabolic and catabolic pathways were thought to be very much intermingled in articular cartilage (Aigner T et al., 2006). Thus, one of the most important questions in osteoarthritis research is to understand the balance of catabolic and anabolic factors in articular cartilage as this is the key to understand the biology of cartilage maintenance and degeneration. Osteoarthritis (OA) of the knee is the major cause of chronic musculoskeletal pain and is ranked as a main cause of mobility disability in elderly population. It is a disease process of uncertain multifactorial etiology, which eventually affects the entire joint. Various etiologic risk factors have been proposed, but the exact pathogenesis for OA knee is still unknown. Many literatures mentioned medial compartment is more commonly involved than the lateral one and the pathogenesis may be different (Neame R et al., 2004; Nunez M et al., 2008). In 2006, we reported that in patients with medial compartment osteoarthritic knees, the prevalence of medial plica was significantly higher than that of others and that two distinct foci of cartilaginous lesion were found on the facing medial femoral condyle in almost all of the patients who had the structure of medial plica (Lyu SR and Hsu CC, 2006). Our further study disclosed the kinematic relationship of the medial plica with the medial femoral condyle during knee motion in vivo (Lyu SR, 2007). In that study, it was revealed that all medial plicae, regardless of their size, would move reciprocally and would keep in touch with the medial femoral condyle and therefore might cause some degree of abrasion on the facing medial femoral condyle during knee motion. Another histomorphological study of the medial plica also implied the close interplay between this structure and the medial femoral condyle (Lyu SR et al., 2009). Moreover, our recent study (Wang HS et al., 2011)