0
Instructional Course Lecture   |    
Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Articular Cartilage. Part I: Tissue Design and Chondrocyte-Matrix Interactions*†
J. A. BUCKWALTER, M.D.‡, IOWA CITY, IOWA; H. J. MANKIN, M.D.§, BOSTON, MASSACHUSETTS
View Disclosures and Other Information
An Instructional Course Lecture, The American Academy of Orthopaedic Surgeons
J Bone Joint Surg Am, 1997 Apr 01;79(4):600-11
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case

Extract

In 1892, Walt Whitman observed that "the narrowest hinge in my hand puts to scorn all machinery."78 Despite the remarkable advances in joint replacement, Whitman's observation stands unchallenged; no current prostheses come close to duplicating the function and durability of synovial joints. These complex structures, developed and progressively refined over hundreds of millions of years1, are formed by an arrangement of multiple distinct tissues, including joint capsule, ligament, meniscus, subchondral bone, synovial tissue, and hyaline articular cartilage. These tissues are self-renewing, respond to alterations in use, and provide stable movement with a level of friction less than that achieved by any prosthetic joint. The tissue that contributes the most to these extraordinary functional capacities is the hyaline articular cartilage15,19. It varies in thickness, cell density, matrix composition, and mechanical properties within the same joint, among joints, and among species2; however, in all synovial joints it consists of the same components, has the same general structure, and performs the same functions. Although it is at most only a few millimeters thick, it has surprising stiffness to compression and resilience; it also has an exceptional ability to distribute loads52,53, thereby minimizing peak stresses on subchondral bone. Perhaps most important, it has great durability; in most people, it provides normal joint function for eighty years or more. No synthetic material approaches this level of performance.
Figures in this Article

    First Page Preview

    View Large
    />
    First page PDF preview
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

     
    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org

    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe





    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    06/29/2012
    PA - Thomas Jefferson University
    03/19/2014
    NY - KINGS COUNTY HOSPITAL CENTER
    04/02/2014
    WV - Charleston Area Medical Center
    12/04/2013
    NY - Icahn School of Medicine at Mount Sinai